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静脉注射免疫球蛋白治疗类固醇抵抗性隐源性机化性肺炎的病例报告

A Case Report of Steroid-Resistant Cryptogenic Organizing Pneumonia Managed with Intravenous Immunoglobulins.

作者信息

Dimala Christian Akem, Patel Urvi, Lloyd Benjamin, Donato Anthony, Kimmel William B, Hallowell Robert, Moss Caitlyn

机构信息

Department of Medicine, Reading Hospital-Tower Health, West Reading, PA, USA.

Department of Pathology, Reading Hospital-Tower Health, West Reading, PA, USA.

出版信息

Case Rep Pulmonol. 2021 Nov 15;2021:9343491. doi: 10.1155/2021/9343491. eCollection 2021.

DOI:10.1155/2021/9343491
PMID:34820143
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8608529/
Abstract

Fewer than ten reported cases of cryptogenic organizing pneumonia (COP) have been managed with intravenous immunoglobulins (IVIg). We report a case of a 72-year-old man who presented with a worsening cough and diffuse opacities on chest radiograph. Following no improvement with antibiotics and negative complementary investigations for infectious, malignant, and autoimmune etiologies, COP was confirmed on lung biopsy. Due to continued clinical deterioration despite high-dose steroids and new severe steroid-induced hallucinations, the patient was placed on intravenous immunoglobulins (IVIg) and mycophenolate mofetil and made a satisfactory recovery. IVIg should be considered as an important steroid-sparing alternative in patients with COP.

摘要

报告的隐源性机化性肺炎（COP）病例中，接受静脉注射免疫球蛋白（IVIg）治疗的不到10例。我们报告一例72岁男性患者，其出现咳嗽加重，胸部X线片显示弥漫性模糊影。在使用抗生素治疗后无改善，且针对感染性、恶性和自身免疫性病因的补充检查均为阴性后，经肺活检确诊为COP。尽管使用了大剂量类固醇，但患者临床症状仍持续恶化，并出现了新的严重类固醇诱导的幻觉，遂给予患者静脉注射免疫球蛋白（IVIg）和霉酚酸酯治疗，患者恢复良好。对于COP患者，应将IVIg视为一种重要的类固醇替代药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/de7f9c4de925/CRIPU2021-9343491.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/89303aa0f0ba/CRIPU2021-9343491.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/a6f031c7d0b0/CRIPU2021-9343491.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/f50408b3baa6/CRIPU2021-9343491.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/f575ccd8e8c4/CRIPU2021-9343491.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/de7f9c4de925/CRIPU2021-9343491.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/89303aa0f0ba/CRIPU2021-9343491.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/a6f031c7d0b0/CRIPU2021-9343491.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/f50408b3baa6/CRIPU2021-9343491.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/f575ccd8e8c4/CRIPU2021-9343491.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/935a/8608529/de7f9c4de925/CRIPU2021-9343491.005.jpg

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