Figure 3.

Clinical course of the patient, a 36-year-old man. Serum ferritin levels, anti-MDA5 Ab titers, trough concentrations of TAC, and treatment interventions are shown. Serum ferritin levels and anti-MDA5 Ab titers decreased during the PE period but re-increased after PE was completed in five sessions. Despite continuing triple therapy, serum ferritin levels fluctuated around baseline levels, and anti-MDA5 Ab titers decreased but remained high. These levels gradually decreased after switching from TAC to TOF. IVCY: intravenous cyclophosphamide, mPSL: methylprednisolone, PE: plasma exchange, PSL: prednisolone, TAC: tacrolimus, TOF: tofacitinib