A case of treatment with voriconazole for chronic progressive pulmonary aspergillosis in a patient receiving tacrolimus for dermatomyositis-associated interstitial lung disease. (2015)

• Record Type: Journal Article
• Authors: Mochizuki, Eisuke; Furuhashi, Kazuki; Fujisawa, Tomoyuki; Enomoto, Noriyuki; Inui, Naoki; Nakamura, Yutaro; Kono, Masato; Hamada, Etsuko; Maekawa, Masato; Suda, Takafumi
• Is Part Of: Respiratory medicine case reports. Volume 16(2015)
• Page Start: 163
• Page End: 165
• Publication Date: 2015
• Subjects: Voriconazole -- Tacrolimus -- Chronic progressive pulmonary aspergillosis -- Dermatomyositis-associated interstitial lung disease -- CYP2C19 -- Drug interaction; Respiratory organs -- Diseases -- Periodicals; Chest -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System -- Periodicals; Chest -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; 616.2
• DOI: 10.1016/j.rmcr.2015.10.008
• Languages: English
• ISSNs: 2213-0071

Abstract

Abstract: We report a successful treatment with voriconazole (VRCZ) for chronic progressive pulmonary aspergillosis (CPPA) in a patient with dermatomyositis-associated interstitial lung disease (DM-ILD) treated with tacrolimus. A 73-year-old man with DM-ILD, treated with tacrolimus and prednisolone, complained of productive cough and his chest X-ray showed infiltration in the left upper lung field. We diagnosed CPPA and added VRCZ. Although we reduced the dose of tacrolimus for drug interaction, serum VRCZ level increased after the treatment. The patient was found to have cytochrome P450 (CYP) 2C19 *2/*2, a genetic polymorphism in poor metabolizers of VRCZ. We adjusted the doses of both drugs and treated him successfully. We recommend performing individual therapeutic drug monitoring (TDM) in CYP-mediated drug interactions and considering the effect of CYP polymorphisms.