Lee Jaehee, Cha Seung Ick, Park Tae In, Park Jae Yong, Jung Tae Hoon, Kim Chang Ho
Department of Internal Medicine, School of Medicine, Kyungpook National University, Korea.
Intern Med. 2011;50(5):475-9. doi: 10.2169/internalmedicine.50.4237. Epub 2011 Mar 1.
Cryptogenic organizing pneumonia (COP) generally responds well to corticosteroids with a favorable outcome. However, it can rapidly worsen and lead to respiratory failure that is refractory to corticosteroids. Adjunctive drugs have been used in refractory cases with various outcomes, but treatment experience is still lacking. We present a case of rapidly progressive COP accompanying air leak syndrome, which showed no prompt response to corticosteroids alone but gradual improvement with the addition of cyclosporine and macrolide. This case report supports the existing literature suggesting that an early therapeutic trial of this drug combination might be considered in COP patients whose condition worsens despite corticosteroid administration.
隐源性机化性肺炎（COP）通常对皮质类固醇反应良好，预后较好。然而，它可能迅速恶化并导致对皮质类固醇难治的呼吸衰竭。辅助药物已用于难治性病例，结果各异，但仍缺乏治疗经验。我们报告一例伴有空气泄漏综合征的快速进展性COP病例，该病例单独使用皮质类固醇无迅速反应，但加用环孢素和大环内酯类药物后逐渐改善。本病例报告支持现有文献，提示对于尽管使用皮质类固醇但病情仍恶化的COP患者，可考虑早期试用这种药物组合。
