Morinaga Ryotaro, Matsunaga Naoko, Iwata Atsuko, Kishi Kenji, Tokimatsu Issei, Nagai Hiroyuki, Kadota Jun-ichi
Second Department of Internal Medicine, Oita University Faculty of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2007 Feb;45(2):166-9.
A 61-year-old woman who had been followed up after resection of lung cancer (adenosquamous cell carcinoma), was admitted to our hospital because of recurrence. She received systemic anticancer chemotherapy and the chief adverse event was leukopenia (Grade 3). Nineteen days after initiating chemotherapy, she suffered painful vesicular eruption on the right upper limb and the right upper hemithorax which was diagnosed as herpes zoster. After treatment with anti-viral drugs the vesicular eruption disappeared, but chest X-ray film revealed a right diaphragmatic relaxation. Although herpes zoster virus usually affects sensory nerves and causes painful vesicular eruption, it can also damage motor nerves. Herpes zoster virus almost affects cranial nerves, but it should be considered as the cause of diaphragmatic paralysis in this case.
一名61岁女性,在肺癌(腺鳞癌)切除术后接受随访,因复发入院。她接受了全身抗癌化疗,主要不良事件为白细胞减少(3级)。化疗开始19天后,她右上肢和右上半胸出现疼痛性水疱疹,被诊断为带状疱疹。经抗病毒药物治疗后,水疱疹消失,但胸部X光片显示右膈松弛。虽然带状疱疹病毒通常影响感觉神经并引起疼痛性水疱疹,但它也可损害运动神经。带状疱疹病毒几乎影响脑神经,但在本病例中应考虑其为膈麻痹的病因。