Kitayama Takaaki, Kitamura Hideya, Hagiwara Eri, Higa Katsuyuki, Okabayashi Hiroko, Oda Tsuneyuki, Baba Tomohisa, Komatsu Shigeru, Iwasawa Tae, Ogura Takashi
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan.
Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Japan.
Intern Med. 2020 Dec 15;59(24):3207-3211. doi: 10.2169/internalmedicine.5630-20. Epub 2020 Oct 21.
An 84-year-old man was admitted with hypoxemia and ground-glass opacities with traction bronchiectasis in both lungs and mild fibrosis on computed tomography. We first suspected that he had acute exacerbation of interstitial pneumonia and initiated methylprednisolone pulse therapy. On day 4, he was diagnosed with coronavirus disease 2019 (COVID-19) pneumonia. Although the ground-glass opacities were improved with corticosteroid treatment alone, the hypoxemia persisted, and the plasma D-dimer level increased. Anticoagulant therapy was initiated, and the hypoxemia was improved. COVID-19 pneumonia may result in radiological findings similar to those of acute exacerbation of interstitial pneumonia, and corticosteroids and anticoagulant therapy may lead to favorable outcomes.
一名84岁男性因低氧血症入院,计算机断层扫描显示双肺有磨玻璃影伴牵拉性支气管扩张及轻度纤维化。我们最初怀疑他患有间质性肺炎急性加重,并开始使用甲泼尼龙冲击疗法。第4天,他被诊断为2019冠状病毒病(COVID-19)肺炎。尽管仅用皮质类固醇治疗后磨玻璃影有所改善,但低氧血症持续存在,血浆D-二聚体水平升高。开始抗凝治疗后,低氧血症得到改善。COVID-19肺炎可能导致与间质性肺炎急性加重相似的影像学表现,皮质类固醇和抗凝治疗可能带来良好预后。