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Diagnosis and management of interstitial pneumonitis associated with interferon therapy for chronic hepatitis C

World Journal of Gastroenterology 2010年第35期16卷 4394-4399页

作者： Fan-Pu Ji Zheng-Xiao Li Hong Deng Hong-An Xue Yuan Liu Min Li Department of Dermatology Second Affiliated Hospital China Yuan Liu Department of Dermatology Second Afliated HospitalCollege of MedicineXi’an Jiaotong UniversityXi’an 710004Shaanxi ProvinceChina Department of Pulmonary Medicine Second Afliated HospitalCollege of MedicineXi’an Jiaotong University Xi’an 710004Shaanxi ProvinceChina Department of Imageology First Affiliated HospitalCollege of MedicineXi’an Jiaotong UniversityXi’an 710061Shaanxi ProvinceChina

interstitial pneumonitis(IP) is an uncommon pulmonary complication associated with interferon(IFN) therapy for chronic hepatitis C virus(HCV) *** can occur at any stage of HCV treatment,ranging from 2 to 48 wk,usually in the first 12 *** most common symptoms are dyspnoea,dry cough,fever,fatigue,arthralgia or myalgia,and anorexia,which are reversible in most cases after cessation of IFN therapy with a mean subsequent recovery time of 7.5 *** lavage in combination with chest high resolution computed tomography has a high diagnostic *** discontinuation of medication is the cornerstone,and corticosteroid therapy may not be essential for patients with mild-moderate pulmonary functional *** severity of pulmonary injury is associated with the rapid development of *** suggest that methylprednisolone pulse therapy followed by low dose prednisolone for a short term is necessary to minimize the risk of fatal pulmonary damage if signs of significant pulmonary toxicity occur in earlier *** should be aware of the potential pulmonary complication related to the drug,so that an early and opportune diagnosis can be made.

关键词： Chronic hepatitis C Interferon α interstitial pneumonitis Management Corticosteroid therapy

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A case of interstitial pneumonitis in a patient with ulcerative colitis treated with azathioprine

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World Journal of Gastroenterology 2007年第2期13卷 316-319页

作者： Ferenc Nagy Tamas Molnar Eva Makula Ildiko Kiss Peter Milassin Eva Zollei Laszlo Tiszlavicz Janos Lonovics First Department of Medicine University of Szeged Faculty of Medicine Szeged Hungary Department of Radiology University of Szeged Faculty of Medicine Szeged Hungary Medical Intensive Care Unit University of Szeged Faculty of Medicine Szeged Hungary Institute of Pathology University of Szeged Faculty of Medicine Szeged Hungary

The early hypersensitivity reaction and late bone marrow depression are well-known side-effects of azathioprine, whereas interstitial pneumonia is a rare complication. A 40-year old male patient had been treated with azathioprine in consequence of extensive ulcerative colitis for 10 years. He then complained of 7 d of fever, cough and catarrhal signs, without symptoms of active colitis. Opportunistic infections were ruled out. The chest X-ray, CT and lung biopsy demonstrated the presence of interstitial inflammation. Azathioprine therapy was discontinued as a potential source of the pulmonary infiltrate. In response to steroid therapy, and intensive care, the pulmonary infiltrate gradually decreased within 4 wk. Three months later, his ulcerative colitis relapsed, and ileo-anal pouch surgery was performed. In cases of atypical pneumonia, without a proven infection, azathioprine-associated interstitial pneumonitis may be present, which heals after withdrawal of the drug.

关键词： Inflammatory bowel disease Ulcerative colitis Azathioprine interstitial pneumonitis

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CYTOMEGALOVIRUS interstitial pneumonitis FOLLOWING ALLOGENEIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION

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Chinese Journal of Cancer Research 2005年第4期17卷 294-297页

作者：许晓华黄连生张晓红朱康儿徐炀吴东赵小英 Department of Hematology Second Hospital of Zhejiang University

Objective： To explore the risk factors and prophylaxis and treatment of cytomegalovirus interstitial pneumonitis （CMV-IP） after allogeneic peripheral blood stem cell transplantation （allo-PBSCT）. Methods： 43 patients who received allo-PBSCT were allocated to either a Gancyclovir（GCV）-prophylaxis group （n=19） or a non-GCV prophylaxis group （n=24）. A comparison was made of the incidence of CMV-IP in patients given or not given prophylactic gancyclovir. Results： 9 patients in non-GCV prophylaxis group developed late CMV-IP （P〈0.05）. Graft-versus-host-disease （GVHD） may be associated with a high risk of CMV-IP. 5 cases of CMV-IP were successfully treated with GCV, but 3 cases died of CMV-IP. The most common adverse event of GCV was neutropenia, but was reversible. Conclusion： CMV infection was a major cause of interstitial pneumonitis after allo-PBSCT, which correlated strongly with the severity of GVHD. Gancyclovir was shown to be effective in both prophylaxis and treatment of CMV-IP.

关键词： Allogeneic Peripheral blood stem cell transplantation interstitial pneumonitis Cytomegalovirus Graft-Versus-Host -Disease

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