Staten Island University Hospital, Department of Medicine, Pulmonary and Critical Care Division, 475 Seaview Ave., Staten Island, NY 10305, USA.
Staten Island University Hospital, Department of Medicine, Pulmonary and Critical Care Division, 475 Seaview Ave., Staten Island, NY 10305, USA.
Heart Lung. 2014 Jan-Feb;43(1):84-6. doi: 10.1016/j.hrtlng.2013.10.010. Epub 2013 Oct 12.
Adalimumab is a fully human monoclonal anti-TNF-alpha antibody. Reported adverse effects have raised a number of safety concerns associated with their prolonged use. A case of granulomatous pneumonitis and hemidiaphragm paresis associated with adalimumab therapy for rheumatoid arthritis is described. In May 2012, a 57 year old male presented with dry cough, dyspnea and orthopnea after 4 months of treatment with adalimumab for rheumatoid arthritis. The patient received adalimumab from November 2011 to February 2012. A right hemidiaphragm elevation was shown on chest radiograph. A right hemidiaphragm paresis was shown on chest fluoroscopy. Bilateral lower lobe interstitial disease was shown on the chest HRCT scan. Open lung biopsy of the right lower lobe showed subacute granulomatous pneumonitis. In July 2013, the patient's respiratory symptoms and the previous restrictive pattern on PFTs resolved. In a same patient, a rare association of hemidiaphragm paresis and granulomatous pneumonitis with adalimumab treatment is herein reported.
阿达木单抗是一种全人源单克隆抗 TNF-α 抗体。报道的不良反应引起了人们对其长期使用相关的安全性的关注。本文报告了一例与阿达木单抗治疗类风湿关节炎相关的肉芽肿性肺炎和膈肌部分麻痹。2012 年 5 月，一名 57 岁男性因类风湿关节炎接受阿达木单抗治疗 4 个月后出现干咳、呼吸困难和端坐呼吸。患者于 2011 年 11 月至 2012 年 2 月接受阿达木单抗治疗。胸部 X 线片显示右侧膈肌抬高。胸部透视显示右侧膈肌麻痹。胸部 HRCT 扫描显示双侧下叶间质性疾病。右肺下叶开胸活检显示亚急性肉芽肿性肺炎。2013 年 7 月，患者的呼吸症状和之前 PFTs 的限制性模式均得到缓解。在同一患者中，报告了一种罕见的与阿达木单抗治疗相关的膈肌部分麻痹和肉芽肿性肺炎的关联。
