Nakajima M, Manabe T, Mitekura H, Hashiguchi K, Niki Y, Matsushima T
Department of Medicine, Kawasaki Medical School, Kurashiki, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Jul;35(7):813-7.
We describe a 67-year-old man in who serum KL-6 levels were measured during drug-induced pneumonia. The patient was hospitalized, because of coughing, fever, and dyspnea on exertion after administration of Sho-saiko-to (herbal medicine). After he was hospitalized, his symptoms were relieved, and the infiltration shadow on chest X-ray films resolved, but after re-administration of Sho-saiko-to, fever and hypoxemia developed. The serum KL-6 level was again high one day after oral re-administration of the drug. However, the level of lactate dehydrogenase in serum was not high after the re-administration. After treatment with on oral steroid drug the serum KL-6 level decreased gradually, symptoms were relieved the previously high level of c-reactive protein in serum decreased, the previously high white blood cell count decreased, and radiographic findings returned to normal. The diagnosis of drug-induced pneumonia is difficult, because specific diagnostic measures have not been developed. In the present case the serum KL-6 level increased rapidly after re-administration of the drug, and therefore measurement of serum KL-6 level may be helpful in the diagnosis of drug-induced pneumonia.
我们描述了一名67岁男性，在药物性肺炎期间检测了其血清KL-6水平。该患者因服用小柴胡汤（草药）后出现咳嗽、发热和劳力性呼吸困难而住院。住院后，他的症状得到缓解，胸部X光片上的浸润影消退，但再次服用小柴胡汤后，发热和低氧血症又出现了。再次口服该药物一天后，血清KL-6水平再次升高。然而，再次给药后血清乳酸脱氢酶水平并不高。经口服类固醇药物治疗后，血清KL-6水平逐渐下降，症状缓解，血清中先前升高的C反应蛋白水平下降，先前升高的白细胞计数下降，影像学检查结果恢复正常。药物性肺炎的诊断很困难，因为尚未开发出特异性诊断方法。在本病例中，再次给药后血清KL-6水平迅速升高，因此检测血清KL-6水平可能有助于药物性肺炎的诊断。
