Makita Shinichi, Munakata Wataru, Watabe Daisuke, Maeshima Akiko Miyagi, Taniguchi Hirokazu, Toyoda Kosuke, Yamauchi Nobuhiko, Fukuhara Suguru, Maruyama Dai, Kobayashi Yukio, Tobinai Kensei
1 Departments of Hematology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
2 Departments of Pharmacy, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
J Int Med Res. 2017 Apr;45(2):886-893. doi: 10.1177/0300060517698331. Epub 2017 Mar 16.
Azacitidine is a first-in-class demethylating agent, and it is widely used globally as a first-line treatment for higher-risk myelodysplastic syndrome (MDS). Here, we report the case of a patient with MDS who suffered from a rare adverse event, an acute lung injury (ALI), which was suspected to have been caused by azacitidine and was successfully treated with corticosteroids. As it is a rare, but critical, adverse event, clinicians should consider ALI as one of the differential diagnoses in cases where 1) pneumonia and fever of unknown etiology arise in MDS patients treated with azacitidine, 2) antimicrobial agents are not effective, and 3) microbiological tests produce negative results.
阿扎胞苷是一流的去甲基化药物，在全球广泛用作高危骨髓增生异常综合征（MDS）的一线治疗药物。在此，我们报告1例MDS患者发生罕见不良事件——急性肺损伤（ALI）的病例，该事件疑似由阿扎胞苷引起，经皮质类固醇成功治疗。由于这是一种罕见但严重的不良事件，临床医生在以下情况时应将ALI列为鉴别诊断之一：1）接受阿扎胞苷治疗的MDS患者出现病因不明的肺炎和发热；2）抗菌药物无效；3）微生物检测结果为阴性。
