Pulmonary Department, Evangelismos General Hospital of Athens, Ypsilanti 45-47, 10676 Athens, Greece.
Heart Lung. 2013 Nov-Dec;42(6):480-2. doi: 10.1016/j.hrtlng.2013.07.005. Epub 2013 Aug 19.
Although poorly understood, interstitial lung disease has been reported as a possible complication of tumor necrosis factor alpha inhibitors. We report a case of interstitial lung disease in a 64-year-old man with psoriasis 3 weeks after the initiation of infliximab treatment. The patient had received two fortnightly infusions of infliximab following a short course of methotrexate. Thoracic computed tomography showed bilateral ground glass and interstitial infiltrates, while the results of microbiology and immunologic workup were negative. Likewise, bronchoalveolar lavage detected neither typical nor atypical pathogens. Infliximab-induced interstitial lung injury was suspected and corticosteroid therapy was administered which resulted in rapid clinical and radiological improvement. This is one of the few reported cases of interstitial lung disease due to infliximab in the psoriasis population. The patient had no pre-existing lung pathology, while his previous exposure to methotrexate was minimal and was not temporally associated with the induction of interstitial lung disease.
尽管间质性肺疾病的发病机制尚不清楚，但已有报道称其可能是肿瘤坏死因子-α抑制剂的一种并发症。我们报告了一例 64 岁男性银屑病患者在使用英夫利昔单抗治疗 3 周后发生间质性肺疾病的病例。该患者在接受甲氨蝶呤短期治疗后，每两周接受两次英夫利昔单抗输注。胸部计算机断层扫描显示双侧磨玻璃影和间质性浸润，而微生物学和免疫学检查结果均为阴性。同样，支气管肺泡灌洗也未检测到典型或非典型病原体。因此，怀疑为英夫利昔单抗诱导的间质性肺损伤，并给予皮质类固醇治疗，患者的临床和影像学状况迅速改善。这是银屑病患者中为数不多的几例因英夫利昔单抗引起的间质性肺疾病报告之一。该患者无既往肺部疾病，而其之前接触甲氨蝶呤的时间很短，且与间质性肺疾病的发生无时间关联。
