線維素溶解素剤エレース^<【○!R】>による薬物性肺臓炎の1例  [in Japanese] Pneumonitis in a Patient Who Inhaled a Fibrinolysin-deoxyribonuclease Mixture  [in Japanese]

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Abstract

線維素溶解酵素剤エレース<sup>®</sup>による薬物性肺臓炎の1例を経験した. 症例は54歳男性. 当院歯科口腔外科にて悪性多形腺腫の手術後, 局所の炎症改善を目的にしてエレース<sup>®</sup>を含む薬剤のネブライザー吸入を開始した. その後, 発熱, 咳嗽等出現し, 胸部X線写真上両側上肺野を中心に斑状影が出現したため, 精査目的にて当科転科. 経気管支肺生検では間質へのリンパ球, 組織球主体の炎症細胞の浸潤と肉芽腫性病変を認め, 気管支肺胞洗浄ではリンパ球の増加を認めた. ステロイド使用後臨床症状や胸部X線所見が改善するも, 当院歯科口腔外科に転科後, 再びエレース<sup>®</sup>を含む薬剤のネブライザー吸入を施行したところ前回と同じ臨床症状が出現, ネブライザーの中止により臨床症状が消失した. リンパ球刺激試験を施行したところ, エレース<sup>®</sup>のみが陽性であり, エレース<sup>®</sup>による薬物性肺臓炎と診断した. エレース<sup>®</sup>による薬物性肺臓炎は本症例が第1例目である.

A 56-year-old man was transferred to our department from the department of oral surgery, with a high fever and a cough. He had inhaled a fibrinolysin-deoxyribonuclease mixture (Elase) to treat inflammation in the oral cavity after resection of an oral tumor. A chest X-ray film showed diffuse patchy shadows in both lung fields. Bronchoalveolar lavage fluid had an abnormally high number of lymphocytes and transbronchial lung biopsy revealed interstitial infiltration by lymphocytes and histiocytes, with granulomatous lesions. The patient was treated with steroids, and his clinical condition improved markedly. He accidentally inhaled the drug again, and the coughing and fever began again. The drug lymphocyte stimulation test was positive only for the fibrinolyspin-deoxyribonuclease mixture. Based on these findings, we diagnosed pneumonitis induced by this fibrinolysin-deoxyribonuclease mixture. To our knowledge, this is the first reported case of pneumonitis caused by this fibrinolysin-doxyribonuclease mixture.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 33(11), 1302-1306, 1995-11-25

    The Japanese Respiratory Society

References:  10

Cited by:  3

Codes

  • NII Article ID (NAID)
    10008108952
  • NII NACSIS-CAT ID (NCID)
    AN00187758
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03011542
  • Data Source
    CJP  CJPref  J-STAGE 
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