Epler G R, Snider G L, Gaensler E A, Cathcart E S, FitzGerald M X, Carrington C B
JAMA. 1979 Aug 10;242(6):528-32.
Rapid onset of severe and irreversbile airflow obstruction developed in two women. One had eosinophilic fasciitis and the other had rheumatoid arthritis. Both were treated with penicillamine. In the first patient, aged 42 years, dyspnea developed after six months of therapy. Her roentgenogram showed hyperinflation. Forced vital capacity expired in one second (FEV1/FVC%) decreased from 75% to 40%, and the residual volume increased by 1 L. In the second patient, aged 54 years, cough and dyspnea developed after ten months of therapy. The FEV1/FVC% was 56%, the FEV1 was 0.9 L, and the roentgenogram was normal. Lung biopsy specimens demonstrated severe and widespread bronchiolitis. An association between obliterative bronchiolitis and rheumatoid arthritis has been reported. Penicillamine may impair healing of bronchiolitis in such patients.
两名女性患者迅速出现严重且不可逆的气流阻塞。其中一名患有嗜酸性筋膜炎，另一名患有类风湿关节炎。两人均接受青霉胺治疗。在第一名42岁的患者中，治疗6个月后出现呼吸困难。她的X线胸片显示肺过度充气。一秒用力呼气容积占用力肺活量的百分比（FEV1/FVC%）从75%降至40%，残气量增加了1升。在第二名54岁的患者中，治疗10个月后出现咳嗽和呼吸困难。FEV1/FVC%为56%，FEV1为0.9升，X线胸片正常。肺活检标本显示严重且广泛的细支气管炎。已有报道闭塞性细支气管炎与类风湿关节炎之间存在关联。青霉胺可能会损害此类患者细支气管炎的愈合。
