Kim Sung-Ho, Minami Seigo, Ogata Yoshitaka, Yamamoto Suguru, Komuta Kiyoshi
Department of ER Medical Center, Osaka Police Hospital, Japan.
Department of Respiratory Medicine, Osaka Police Hospital, Japan.
Intern Med. 2017;56(13):1697-1700. doi: 10.2169/internalmedicine.56.8349. Epub 2017 Jul 1.
We herein report a 73-year-old Japanese woman with metastatic thymic carcinoma who developed diffuse alveolar hemorrhage (DAH) during irinotecan chemotherapy. She presented with a mild fever and exertional dyspnea after the second cycle of weekly irinotecan monotherapy. Chest images showed diffuse ground-glass opacities. The diagnosis of DAH was based on the findings of the bronchoalveolar lavage fluid, which was bloody and contained hemosiderin-laden macrophages. The discontinuation of irinotecan and introduction of oral prednisolone improved her symptoms and chest abnormal shadows. This is the first case of DAH caused by irinotecan.
我们在此报告一名73岁的日本女性转移性胸腺癌患者，在接受伊立替康化疗期间发生弥漫性肺泡出血（DAH）。她在每周一次的伊立替康单药化疗第二个周期后出现低热和劳力性呼吸困难。胸部影像显示弥漫性磨玻璃影。DAH的诊断基于支气管肺泡灌洗液检查结果，其呈血性且含有含铁血黄素巨噬细胞。停用伊立替康并开始口服泼尼松龙后，她的症状和胸部异常阴影有所改善。这是首例由伊立替康引起的DAH病例。
