The Beneficial Effect of 3-Month-Induction Therapy with Corticosteroids and Mycophenolate Mofetil Followed by Maintenance Therapy with Yearly Rituximab Infusions as Sole Maintenance Therapy in Cryptogenic Chronic Hypersensitivity Pneumonitis

Background: The available data on cryptogenic chronic hypersensitivity pneumonitis (ccHP) indicate an inherited predisposition to disease with triggering autoimmune phenomena. Hence, we evaluated prospectively the role of a new regimen in treatment its severe and progressive disease. Patients Methods: A total 9 patients were included study. They had criteria for ccHP viz. 1) clinical features restrictive lung disease, 2) high-resolution computed tomographic pulmonary abnormalities, 3) bronchoalveolar lavage lymphocytosis (>30%). consisted initial induction phase 3-month Solumedrol 1 g IV daily 3 days followed by month Prednisone (P) 60 mg/day tapered down discontinuation 3rd month. also received Mycophenolate mofetil (MMF) twice months. This stage was maintenance yearly Rituximab infusions (1 2 weeks later). Results: compared their previous 6 months deterioration; all showed significant improvement forced vital volume, diffusion capacity carbon monoxide, 6-minutes-walk after (at months) which improved further at 15 therapy. Conclusion: After therapy P MMF; R is safe, practical effective long-term ccHP.