Successful treatment of primary Sjögren's syndrome with chronic natural killer lymphocytosis by high-dose prednisolone and indomethacin farnesil

Intern Med. 2007;46(5):251-4. doi: 10.2169/internalmedicine.46.1881. Epub 2007 Mar 1.

Abstract

We report a patient with Sjögren's syndrome and chronic natural killer lymphocytosis, who developed severe neutropenia, autoimmune hemolytic anemia, and immune thrombocytopenia. High-dose prednisolone therapy improved the hemolytic anemia and thrombocytopenia, but not the CD16(+) CD56(-) NK lymphocytosis completely. Interestingly, indomethacin farnesil (a prodrug of indomethacin) was effective for myalgia and also decreased the number of CD16(+) CD56(-) NK cells. NK lymphocytosis is rarely associated with autoimmune disease, but the combination of indomethacin and steroid therapy may have a favorable effect for such patients.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Chronic Disease
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Indomethacin / analogs & derivatives*
  • Indomethacin / therapeutic use
  • Killer Cells, Natural / pathology*
  • Lymphocytosis / etiology*
  • Lymphocytosis / pathology
  • Prednisolone / therapeutic use*
  • Sialadenitis / etiology
  • Sialadenitis / pathology
  • Sjogren's Syndrome / complications*
  • Sjogren's Syndrome / drug therapy*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Glucocorticoids
  • Prednisolone
  • indomethacin farnesil
  • Indomethacin