Umeki S, Kato H, Hashiguchi K, Yagi S, Soejima R, Harada M
Department of Medicine, Kawasaki Medical School, Kurashiki, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Jul;29(7):885-92.
A 76-year-old woman was admitted with exertional dyspnea and chest roentgenographical abnormal shadows appearing after oral gold therapy (total 720 mg) for rheumatoid arthritis. Based on the patient's clinical course, chest roentgenograms, chest CT and pathological findings of TBLB specimens, gold pneumonitis was diagnosed. Steroid therapy improved symptoms and pulmonary function and cotton-like shadows on chest roentgenograms and chest CT scanning. However, linear and large ringed shadows on chest roentgenograms and chest CT scan remained, even after steroid therapy. This case is the first case of oral gold tablet-induced pneumonitis. Although the mechanism of oral gold tablet-induced pneumonitis is considered to be almost the same that of gold injection therapy-induced pneumonitis, this case suggested that fibrotic changes in oral gold tablet-induced pneumonitis may be delayed over a long period.
一名76岁女性因类风湿关节炎接受口服金制剂治疗（总量720mg）后出现劳力性呼吸困难及胸部X线片异常阴影而入院。根据患者的临床病程、胸部X线片、胸部CT及经支气管肺活检标本的病理结果，诊断为金制剂肺炎。类固醇治疗改善了症状、肺功能以及胸部X线片和胸部CT扫描上的棉絮状阴影。然而，即使在类固醇治疗后，胸部X线片和胸部CT扫描上的线状和大环状阴影仍存在。该病例是口服金片诱发肺炎的首例。尽管口服金片诱发肺炎的机制被认为与金注射疗法诱发肺炎的机制几乎相同，但该病例表明口服金片诱发肺炎的纤维化改变可能会长期延迟出现。
