Remarkable Improvement in Clinical Course and Serum KL-6 Levels after Initiation of High-Dose Inhaled Budesonide in Pulmonary Sarcoidosis

Kurume Med J. 2020 Jul 1;66(1):71-75. doi: 10.2739/kurumemedj.MS661003. Epub 2020 May 1.

Abstract

We present a pulmonary sarcoidosis patient with specific elevation of serum Krebs von den lungen-6 (KL-6) levels, who was successfully treated with inhaled corticosteroids. Pulmonary sarcoidosis was initially identified as a chest radiograph abnormality during a routine medical examination, and subsequently confirmed by a high serum level of soluble interleukin 2 receptor. The patient was started on high-dose inhaled budesonide because of high serum levels of angiotensin-converting enzyme (ACE) and KL-6. Following treatment, radiographic findings improved, ACE levels normalized, and serum KL-6 levels markedly decreased. No recurrence was detected at 100 months with a budesonide dosage of 800 μg/day. This case demonstrates the efficacy of highdose inhaled corticosteroids for the initial treatment of pulmonary sarcoidosis.

Keywords: KL-6; alveolar-capillary membrane permeability; inhaled corticosteroid, budesonide; pulmonary sarcoidosis; sarcoidosis-associated interstitial lung disease.

Publication types

  • Case Reports

MeSH terms

  • Budesonide* / therapeutic use
  • Glucocorticoids* / administration & dosage
  • Humans
  • Mucin-1 / blood
  • Peptidyl-Dipeptidase A / blood
  • Sarcoidosis, Pulmonary* / blood
  • Sarcoidosis, Pulmonary* / drug therapy

Substances

  • Glucocorticoids
  • MUC1 protein, human
  • Mucin-1
  • Budesonide
  • Peptidyl-Dipeptidase A