Patient was of 40 year-old male with fever, severe muscular pain and polyarthralgia.
He had been suffered from these symptoms scince June 1975, and was admitted to Akashi Municipal Hospital on July 15. The arteriolar inflammation peculiar to periarteritis nodosa (PN) was observed with his biopsied specimen of leg nodule soon after admission, and he was diagnosed as PN.
40mg/day of prednisolone was administrated to him for 3 weeks immediatory after diagnosis without response. Therefore 100mg/day of azathioprine with 40mg/day of prednisolone was administrated, but had no effect for further 5 weeks. Then 1, 500mg/day of t-AMCHA was orally given to the pt. After few days, the pain and inflammatory symptoms were obviously improved.
Antiplasmic compound “t-AMCHA” has also anti-inflammatory effect, and this is generally different from antiplasmic effect. The leading report of the pharmacological mechanism of this anti-inflammatory effect is said to be, in a part, inactivation of ACTH, but Yamasaki has reported that anti-inflammatory effect of t-AMCHA was observed in adrenolectomized rat. Therefore, clear pharmacological mechanism of t-AMCHA is as yet obscure.
Judging from immediate anti-inflammatory effect of t-AMCHA in our case, we speculate the anti-inflammatory effect is not brought through adrenal gland. And we think t-AMCHA is one of the adequate agent in the treatment of PN, especilly in a non-responsive case to glucocorticoid and/or immunosuppressive therapy.
