CASE REPORT article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1639593
INHALED TREPROSTINIL: AN ALTERNATIVE FOR THE TREATMENT OF REFRACTORY EXACERBATION OF INTERSTITIAL LUNG DISEASE
Provisionally accepted
FRANCISCO XAVIER LEON ROMAN*
BEATRIZ PINTADO-CORTGABRIEL LARGAESPADA-PEREZHANNY G KHANDJI-ASLANFRANCISCO MUÑIZ-GONZALEZ- Hospital Recoletas Campo Grande, Valladolid, Spain
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Acute exacerbation of interstitial lung disease is associated with poor prognosis. Evidence on the best therapeutic strategy for affected patients is lacking. Corticosteroids, broad-spectrum antibiotics, and oxygen therapy are the mainstay of treatment, although immunosuppressants can be added in refractory exacerbations. We present the case of an acute exacerbation in a patient with unclassifiable interstitial lung disease and a history of lymphoma in complete remission. Despite treatment with high-dose corticosteroids, antibiotics, rituximab, and cyclophosphamide, significant hypoxemia persisted, preventing discharge. Echocardiography indicated an intermediate probability of pulmonary hypertension. Subsequent right heart catheterization confirmed precapillary pulmonary hypertension. Inhaled treprostinil was started once other possible causes of pulmonary hypertension had been ruled out. The patient's condition gradually improved. Treprostinil has been shown to be effective in the treatment of pulmonary hypertension associated with interstitial lung disease. Furthermore, its potential antifibrotic effect is currently being investigated. In the present case, we believe that treating both conditions led to clinical and radiological improvement. However, the limitations of a case report require more robust studies to be performed before firm clinical recommendations can be made.
Keywords: treprostinil, exacerbation, Interstitial Lung Disease, Treatment, refractary
Received: 02 Jun 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 LEON ROMAN, PINTADO-CORT, LARGAESPADA-PEREZ, KHANDJI-ASLAN and MUÑIZ-GONZALEZ. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: FRANCISCO XAVIER LEON ROMAN, Hospital Recoletas Campo Grande, Valladolid, Spain
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