Yokoyama Toshiki, Tsushima Kenji, Yamamoto Hiroshi, Ito Michiko, Agatsuma Toshihiko, Kozumi Tomonobu, Kubo Keishi
The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Intern Med. 2010;49(1):59-64. doi: 10.2169/internalmedicine.49.2213. Epub 2010 Jan 1.
The effects of direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) treatment for acute exacerbation of interstitial pneumonia have been reported. Here, we report 3 severe cases of drug-induced interstitial lung disease (DI-ILD) that were treated with PMX-DHP. Two DI-ILD cases were caused by methotrexate, and the third case was caused by the herbal medicine sanmotsu-ogon-to. The arterial oxygen tension/inspiratory oxygen fraction ratio improved during PMX-DHP treatment in all 3 patients. Finally, 2 patients survived and 1 died. The study findings indicate that PMX-DHP treatment is a viable option for the management of acute respiratory failure in patients with DI-ILD.
多黏菌素B固定化纤维直接血液灌流（PMX-DHP）治疗间质性肺炎急性加重的效果已有报道。在此，我们报告3例接受PMX-DHP治疗的药物性间质性肺病（DI-ILD）重症病例。2例DI-ILD病例由甲氨蝶呤引起，第3例由草药三物黄芩汤引起。所有3例患者在PMX-DHP治疗期间动脉血氧分压/吸入氧分数比值均有所改善。最后，2例患者存活，1例死亡。研究结果表明，PMX-DHP治疗是DI-ILD患者急性呼吸衰竭管理的一种可行选择。
