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Interstitial Pneumonia with HLA-B54 Antigen that Responded Well to Erythromycin

Hiroshi Ishimoto1, Noriho Sakamoto1, Atsuko Hara1

  • 1Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.

Internal Medicine (Tokyo, Japan)
|April 25, 2022
PubMed

Insights

Long-term macrolide therapy improved interstitial pneumonia in a patient with honeycomb lung and sinusitis. The human leukocyte antigen (HLA)-B54 antigen may indicate suitability for this treatment.

Area of Science:

  • Pulmonology
  • Immunogenetics

Background:

  • Interstitial pneumonia presents with diverse radiological and cellular findings.
  • Diffuse panbronchiolitis shares some features with interstitial pneumonia but has distinct HRCT patterns.

Observation:

  • A 65-year-old Japanese male with interstitial pneumonia showed honeycomb lung on HRCT and neutrophilic bronchoalveolar lavage.
  • The patient also had sinusitis and was positive for the human leukocyte antigen (HLA)-B54 antigen.

Findings:

  • Long-term macrolide therapy led to significant clinical improvement, including reduced cough and sputum.
  • Radiological evidence of decreased honeycomb lung wall thickening and increased forced vital capacity were observed.
  • The patient's HLA-B54 antigen status was noted.

Implications:

  • The human leukocyte antigen (HLA)-B54 antigen may serve as a predictive biomarker for macrolide therapy response in interstitial pneumonia.
  • This finding could guide treatment decisions for interstitial pneumonia patients, particularly those with overlapping features or specific genetic markers.
Keywords:
HLA-B54 antigendiffuse panbronchiolitiserythromycininterstitial pneumoniamacrolide

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