Jin Fan, Wang Shao-Ting
Department of Internal Medicine.
Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2019 Jan;98(1):e14017. doi: 10.1097/MD.0000000000014017.
Chronic eosinophilic pneumonia (CEP) is rare and an idiopathic disorder. The disease has been associated with drugs, infection, or irradiation, and its relationship with asthma remains unclear.
We reported a case of a 49-year-old female patient after trastuzumab and radiation therapy for breast cancer. Two months after radiation treatment, the patient complained of productive cough, progressive breathlessness, occasional wheezing, and left pectoralgia.
Computed tomography (CT) scan revealed infiltrates in lungs. Without evidence of infection, marked increased eosinophils in a transbronchial biopsy performed from the left upper lobe confirmed the diagnosis of CEP after trastuzumab and radiation therapy.
The patient was started with oral prednisone at 0.5 mg/kg/day.
A CT scan of the chest obtained 2 weeks after steroid treatment showed diminishment of the lesions, and at the 6-month follow-up, the patient had no complaints of discomfort with no relapse of pulmonary lesions.
Physicians should consider CEP as a diagnosis in patients who have had previous exposure to trastuzumab and radiation therapy, especially with a history of asthma. Timely diagnosis and treatment may benefit these patients.
慢性嗜酸性粒细胞性肺炎（CEP）较为罕见，是一种特发性疾病。该疾病与药物、感染或辐射有关，其与哮喘的关系尚不清楚。
我们报告了一例49岁女性患者，她接受了针对乳腺癌的曲妥珠单抗和放射治疗。放射治疗两个月后，患者出现咳痰、进行性呼吸困难、偶尔喘息和左胸痛。
计算机断层扫描（CT）显示肺部有浸润影。在没有感染证据的情况下，左上叶经支气管活检显示嗜酸性粒细胞显著增多，确诊为曲妥珠单抗和放射治疗后发生的CEP。
患者开始口服泼尼松，剂量为0.5毫克/千克/天。
类固醇治疗2周后进行的胸部CT扫描显示病变减轻，在6个月的随访中，患者无不适主诉，肺部病变无复发。
医生应将CEP作为曾接受曲妥珠单抗和放射治疗患者的诊断考虑，尤其是有哮喘病史的患者。及时诊断和治疗可能使这些患者受益。
