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地诺单抗引起的继发性机化性肺炎。

Secondary Organising Pneumonia Caused by Denosumab.

作者信息

Ouakidi Djalaleddine, Bourouis Bouchra Nesrine, Banat Mohammed Amine, Azzi Nesrine, Benzait Siham, Snouber Abdelmadjid

机构信息

Department of Pulmonology, Faculty of Medicine, University of Oran 1, Algeria.

出版信息

Eur J Case Rep Intern Med. 2023 Sep 15;10(10):004043. doi: 10.12890/2023_004043. eCollection 2023.

Abstract

INTRODUCTION

Organising pneumonia belongs to diffuse interstitial lung diseases; we distinguish the cryptogenic organising pneumonia, which is idiopathic, from the secondary organising pneumonia caused by drugs or a defined cause. Denosumab is a human monoclonal antibody, rarely inducing adverse pulmonary effects.

CASE DESCRIPTION

A 57-year-old female patient was admitted to our chest clinic for acute respiratory distress. She was treated with denosumab for severe osteoporosis. The patient described a dry cough and dyspnoea over the previous four months, increased after the last injection of denosumab. A high-resolution computed tomography scan showed bilateral basal parenchymal condensations. The aetiological investigation did not reveal any infectious or immunological origin. The favourable computed tomography imaging and clinical evolution after corticosteroid therapy led to the diagnosis of drug-induced organising pneumonia.

CONCLUSION

Denosumab could induce organising pneumonia. Therefore, clinicians should be aware of this pulmonary toxicity.

LEARNING POINTS

To the best of our knowledge denosumab, a human monoclonal antibody, may rarely induce organising pneumonia.Despite this, we advocate that clinicians be aware that exposure to this drug can cause pulmonary toxicity.The taking of denosumab by our patient does not in any way prove the causal link.

摘要

引言

机化性肺炎属于弥漫性间质性肺疾病;我们将特发性的隐源性机化性肺炎与由药物或明确病因引起的继发性机化性肺炎区分开来。地诺单抗是一种人单克隆抗体,很少引起肺部不良反应。

病例描述

一名57岁女性患者因急性呼吸窘迫入住我院胸科门诊。她因严重骨质疏松接受地诺单抗治疗。患者自述在过去四个月里有干咳和呼吸困难症状,在最后一次注射地诺单抗后加重。高分辨率计算机断层扫描显示双侧基底实质实变。病因调查未发现任何感染或免疫源性病因。皮质类固醇治疗后计算机断层扫描影像改善及临床病情好转,从而诊断为药物性机化性肺炎。

结论

地诺单抗可诱发机化性肺炎。因此,临床医生应意识到这种肺部毒性。

经验教训

据我们所知,人单克隆抗体地诺单抗可能很少诱发机化性肺炎。尽管如此,我们主张临床医生应意识到接触这种药物会导致肺部毒性。我们的患者使用地诺单抗并不能证明存在因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f669/10545148/7f0936279deb/4043_Fig1.jpg

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