Newsome Scott D, Xue Lanny Y, Jennings Timothy, Castaneda Glenn Y
Department of Neurology, Albany Medical Center, Albany, NY 12208, USA.
J Child Neurol. 2007 May;22(5):628-30. doi: 10.1177/0883073807302602.
The authors report the first case of levetiracetam-induced diffuse interstitial lung disease. The patient is a 9-year-old girl who was admitted to the pediatric intensive care unit for aspiration pneumonia. She has a history of epilepsy, cerebral palsy, mental retardation, asthma, and repeated hospitalizations for presumed aspiration pneumonia, which resolved with conventional medical treatment. She has been on low-dose levetiracetam for her epilepsy over the past 2 years, and the dosage was increased just prior to this admission. However, this time, with conventional treatment, the patient's aspiration pneumonia did not improve, which led to a lung biopsy. The biopsy demonstrated a diffuse interstitial process of relatively recent onset, with features consistent with diffuse lung disease. Levetiracetam was implicated in the pathogenesis of the interstitial pneumonitis. The patient improved clinically after the discontinuation of levetiracetam and with the treatment of steroids.
作者报告了首例左乙拉西坦诱发的弥漫性间质性肺病病例。患者为一名9岁女孩，因吸入性肺炎入住儿科重症监护病房。她有癫痫、脑瘫、智力发育迟缓、哮喘病史，曾因疑似吸入性肺炎多次住院，经传统药物治疗后病情缓解。在过去2年里，她一直服用低剂量左乙拉西坦治疗癫痫，此次入院前剂量有所增加。然而，这次经传统治疗后，患者的吸入性肺炎并未改善，遂进行了肺活检。活检显示为近期起病的弥漫性间质病变，其特征与弥漫性肺病相符。左乙拉西坦被认为与间质性肺炎的发病机制有关。停用左乙拉西坦并给予类固醇治疗后，患者临床症状有所改善。
