Panduranga Veena, Atienza Jonessa, Kumar Anupam, Metersky Mark L
University of Connecticut Internal Medicine Residency Program, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT 06030, USA.
Conn Med. 2013 Feb;77(2):87-90.
Hypersensitivity pneumonitis (HP) is a rare adverse event with flavocoxid (Limbrel) use. Patients present with nonspecific symptoms after exposure to an inciting agent.
A 42-year-old female presented with worsening dyspnea on exertion and pleuritic midsternal chest pain. Her symptoms failed to abate with outpatient azithromycin for a diagnosis of community-acquired pneumonia. She was seen again at the emergency department (ED) due to symptom progression and exertional hypoxia. Chest reoentgenogram (x-ray) and computed tomography (CT) chest revealed bilateral infiltrates. Her history was significant for initiation of flavocoxid (Limbrel) two weeks prior, and a diagnosis of hypersensitivity pneumonitis was made. Once flavocoxid was discontinued, symptoms and radiologic studies improved without requiring biopsy or steroids.
Hypersensitivity pneumonitis is associated with many pharmacological agents and is challenging to diagnose, given nonspecific symptoms and radiologic findings. In the absence of specific indications to use corticosteroids, symptoms of HP might resolve with cessation of the offending agent, as proven by this case.
使用氟考昔（Limbrel）引发的过敏性肺炎（HP）是一种罕见的不良事件。患者在接触诱发因素后会出现非特异性症状。
一名42岁女性出现劳力性呼吸困难加重和胸骨中下段胸膜炎性胸痛。她因疑似社区获得性肺炎接受门诊阿奇霉素治疗，但症状未缓解。由于症状进展和劳力性缺氧，她再次到急诊科就诊。胸部X线片和胸部计算机断层扫描（CT）显示双侧浸润影。她的病史显示两周前开始使用氟考昔（Limbrel），随后被诊断为过敏性肺炎。停用氟考昔后，症状和影像学检查结果均有改善，无需进行活检或使用类固醇。
过敏性肺炎与多种药物有关，鉴于其非特异性症状和影像学表现，诊断具有挑战性。如本病例所示，在没有使用皮质类固醇的特定指征的情况下，停用致病药物后HP症状可能会缓解。
