Vethanayagam D, Pugsley S, Dunn E J, Russell D, Kay J M, Allen C
Department of Medicine, St Joseph's Hospital, Hamilton, Ontario, Canada.
Can Respir J. 2000 Jul-Aug;7(4):338-42. doi: 10.1155/2000/248915.
A 30-year-old female presented shortly after cadaveric renal transplantation with respiratory distress typical of a bacterial infection. Following initial improvement, she developed progressive respiratory failure, initially felt to be secondary to cytomegalovirus infection. Two bronchoalveolar lavages were nondiagnostic, and an open lung biopsy was performed, which revealed a pulmonary alveolar proteinosis (PAP) reaction and exogenous lipid pneumonia (ELP). The ELP was considered to be secondary to the use of marijuana, in the form of weed oil, that was smoked daily for over 10 years and stopped just before renal transplantation. This is the first description of both PAP and ELP following renal transplantation, and the first description of ELP related to smoking weed oil. Physicians should be aware of the different forms of marijuana available and of their potential medical complications.
一名30岁女性在尸体肾移植后不久出现典型细菌感染所致的呼吸窘迫。最初病情改善后，她出现进行性呼吸衰竭，起初认为是巨细胞病毒感染所致。两次支气管肺泡灌洗均未明确诊断，遂进行了开胸肺活检，结果显示为肺泡蛋白沉积症（PAP）反应和外源性脂质性肺炎（ELP）。ELP被认为是由于使用大麻油形式的大麻所致，患者每天吸食大麻油超过10年，且在肾移植前刚刚停止。这是肾移植后PAP和ELP的首次描述，也是与吸食大麻油相关的ELP的首次描述。医生应了解大麻的不同形式及其潜在的医学并发症。
