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Post COVID-19 organizing pneumonia treated with mycophenolate mofetil
Hui Xin Tan1, Chee Kin Wong1, Weng Fai Yik1
1Respiratory Department Hospital Raja Permaisuri Bainun Ipoh Malaysia.
Respirology Case Reports
|October 7, 2022
Summary
Mycophenolate Mofetil (MMF) shows promise for treating organizing pneumonia (OP) post-COVID-19 that is resistant to steroids. This immunomodulator aided patients unresponsive to corticosteroids, suggesting a potential role in difficult OP cases.
Area of Science:
- Pulmonology
- Infectious Diseases
- Immunology
Background:
- Organizing pneumonia (OP) typically responds well to corticosteroid therapy.
- A subset of patients with OP exhibit resistance or relapse during corticosteroid tapering.
- Post-COVID-19 organizing pneumonia presents unique challenges in management.
Observation:
- Two cases of post-COVID-19 OP with inadequate response to corticosteroids are presented.
- One patient experienced steroid toxicity and suboptimal response, improving with Mycophenolate Mofetil (MMF).
- Another patient relapsed during steroid tapering and improved with clarithromycin and MMF, though MMF-induced colitis occurred.
Findings:
- Mycophenolate Mofetil (MMF) demonstrated clinical improvement in corticosteroid-resistant or relapsing post-COVID-19 OP.
- MMF facilitated corticosteroid weaning in one patient with suboptimal response.
- MMF can be a viable option for difficult-to-treat post-COVID-19 OP, despite potential side effects.
Implications:
- Mycophenolate Mofetil (MMF) may be a valuable therapeutic option for refractory or relapsing organizing pneumonia (OP) following COVID-19 infection.
- Further research is warranted to establish the efficacy and safety of MMF in managing difficult post-COVID-19 OP.
- Immunomodulators like MMF could expand treatment strategies for steroid-resistant organizing pneumonia beyond COVID-19 contexts.
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