Correct!
5. All of the above
All have been used for therapy. High dose methylprednisolone is often given at 1 gram daily for 3 days, then prednisone at 1 mg/kg. Cyclophosphamide is usually given at 2 mg/kg daily up to 200 mg. Rituximab is given weekly for 4 weeks. Plasma exchange can be used in patients critically ill. The corticosteroids are usually tapered with azathioprine or methotrexate usually given for maintenance therapy. None has been shown to be superior therapy (3).
The patient was given 1 gram solumedrol initially for 3 days and a rituximab infusion. He showed marked improvement. He was discharged taking 60 mg of prednisone daily and scheduled for Rituximab infusions. His pleuritic chest pain resolved and his follow up chest X-ray showed marked improvement (Figure 4).
Figure 4. Follow up chest x-ray taken at the time of discharge from the hospital.
References