Ikegawa Kayoko, Hanaoka Masayuki, Ushiki Atsuhito, Yamamoto Hiroshi, Kubo Keishi
The First Department of Internal Medicine, Shinshu University School of Medicine, Japan.
Intern Med. 2011;50(19):2191-3. doi: 10.2169/internalmedicine.50.5497. Epub 2011 Oct 1.
A 66-year-old woman rheumatoid arthritis was treated with methotrexate and tocilizumab. Chest radiography revealed bilateral consolidation of an upper lesion in the lung. Laboratory data indicated a hepatic disorder and increased eosinophils. Transbronchial lung biopsy specimens showed organizing pneumonia. Infection was unfavorable based on culture and PCR. Drug lymphocyte stimulation test showed positive results both for methotrexate and tocilizumab. We were concerned that her pneumonitis was drug-induced. And the symptoms appeared after the infusion of tocilizumab. Here, we report a case of tocilizumab-induced organizing pneumonia.
一名66岁患类风湿性关节炎的女性接受了甲氨蝶呤和托珠单抗治疗。胸部X线检查显示肺部上叶双侧实变。实验室数据表明存在肝脏疾病且嗜酸性粒细胞增多。经支气管肺活检标本显示为机化性肺炎。基于培养和聚合酶链反应结果排除感染。药物淋巴细胞刺激试验显示甲氨蝶呤和托珠单抗均呈阳性结果。我们怀疑她的肺炎是药物引起的。症状在输注托珠单抗后出现。在此，我们报告一例托珠单抗诱导的机化性肺炎病例。
