McCarthy Eilís, McClain Erik
Tallaght University Hospital, Dublin, Ireland.
Thames Hospital, Waikato, New Zealand.
Eur J Case Rep Intern Med. 2019 Jun 17;6(6):001067. doi: 10.12890/2019_001067. eCollection 2019.
Methamphetamine is a substance of abuse that is most commonly smoked. Both regular and non-regular use can cause toxic injury to the lung parenchyma, the signs and symptoms of which are non-specific. Clinical scenarios include non-cardiac pulmonary oedema, acute respiratory distress syndrome, alveolar haemorrhage, pneumonia and pneumoconiosis. As radiological imaging is often non-specific, a positive history of methamphetamine use is the only way to reach a definite diagnosis. The use of methamphetamine is now increasing in Europe, so it is important as physicians to be aware of this differential diagnosis in patients in respiratory distress with risk factors for illicit drug use.
A case of methamphetamine-induced lung injury with non-specific findings is described.In those presenting with respiratory symptoms and no obvious cause identified, consideration must be given to a diagnosis of drug-induced lung injury.Treatment for methamphetamine-induced lung injury is supportive, for example with oxygen supplementation, and symptoms should resolve after cessation of use; there is no evidence that steroids are of benefit.
甲基苯丙胺是一种最常通过吸食滥用的物质。无论是经常使用还是偶尔使用,都可对肺实质造成毒性损伤,其体征和症状并无特异性。临床情况包括非心源性肺水肿、急性呼吸窘迫综合征、肺泡出血、肺炎和尘肺。由于放射影像学表现往往不具特异性,有甲基苯丙胺使用史阳性是明确诊断的唯一途径。目前在欧洲,甲基苯丙胺的使用呈上升趋势,因此作为医生,对于有非法药物使用风险因素且出现呼吸窘迫的患者,了解这种鉴别诊断很重要。
描述了一例甲基苯丙胺所致肺损伤且表现不具特异性的病例。对于出现呼吸道症状且未发现明显病因的患者,必须考虑药物性肺损伤的诊断。甲基苯丙胺所致肺损伤的治疗是支持性的,例如补充氧气,停用后症状应会缓解;没有证据表明类固醇有益。