Mochizuka Yasutaka, Fujisawa Tomoyuki, Inoue Yusuke, Hozumi Hironao, Suzuki Yuzo, Karayama Masato, Furuhashi Kazuki, Enomoto Noriyuki, Nakamura Yutaro, Inui Naoki, Suda Takafumi
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Respir Med Case Rep. 2022 Mar 15;37:101632. doi: 10.1016/j.rmcr.2022.101632. eCollection 2022.
We report herein a case of trimethoprim-sulfamethoxazole (TMP-SMX) induced eosinophilic pneumonia in a 27-year-old woman with radiological features of bilateral nonsegmental airspace consolidation resembling cryptogenic organizing pneumonia at the peripheral lung fields. Organizing pneumonia with eosinophil infiltration in the lung specimens and marked eosinophilia in the peripheral blood and bronchoalveolar lavage fluid were observed. Discontinuation of TMP-SMX improved eosinophilia and radiological abnormality, which confirmed the association between the use of TMP-SMX and onset of eosinophilic pneumonia. Although TMP-SMX induced eosinophilic pneumonia is not common, clinician should be aware that drug-induced eosinophilic pneumonia could happen during the course of TMP-SMX administration.
我们在此报告一例27岁女性因服用甲氧苄啶-磺胺甲恶唑（TMP-SMX）诱发嗜酸性粒细胞性肺炎的病例，其影像学特征为双侧非节段性气腔实变，类似于外周肺野的隐源性机化性肺炎。在肺标本中观察到有嗜酸性粒细胞浸润的机化性肺炎，在外周血和支气管肺泡灌洗液中观察到明显的嗜酸性粒细胞增多。停用TMP-SMX后，嗜酸性粒细胞增多和影像学异常得到改善，这证实了TMP-SMX的使用与嗜酸性粒细胞性肺炎发病之间的关联。虽然TMP-SMX诱发的嗜酸性粒细胞性肺炎并不常见，但临床医生应意识到在TMP-SMX给药过程中可能会发生药物性嗜酸性粒细胞性肺炎。
