奥拉帕利致嗜酸粒细胞增多性肺炎  

Olaparib‑induced eosinophilic pneumonia

作　　者：孙红玲 Sun Hongling(Department of Pharmacy,Yuzhou City People′s Hospital,He′nan Province,Yuzhou 461670,China)

机构地区：[1]河南省禹州市人民医院药学部,禹州461670

出　　处：《药物不良反应杂志》2024年第1期53-55,共3页Adverse Drug Reactions Journal

摘　　要：1例61岁男性前列腺癌、骨髓转移癌患者,经多种抗肿瘤方案效果不佳,予奥拉帕利治疗,病情稳定且耐受性良好。5个月后,患者出现低热、咳嗽、胸闷、气促症状,实验室检查示嗜酸粒细胞计数0.85×10^(9)/L、嗜酸粒细胞0.08;胸部CT检查示双肺支气管炎伴左肺上叶舌段炎性改变。给予抗感染及扩张气管等药物治疗,症状缓解不明显;胸部CT复查示左肺炎性改变范围稍扩大、增多,双肺间质性炎性改变及机化性改变;肺泡灌洗液细胞学检测提示嗜酸粒细胞增多。考虑可能为奥拉帕利引起的嗜酸粒细胞增多性肺炎,停用奥拉帕利并予甲泼尼龙40 mg静脉滴注、1次/d和抗感染治疗。患者未再发热,咳嗽减轻,胸闷、气促症状明显好转。1周后停用甲泼尼龙,但次日患者发热及呼吸道症状加重。再次给予甲泼尼龙,患者未再发热,咳嗽、胸闷、气促症状均明显好转。7 d后胸部CT复查示肺部间质性炎性改变明显好转。A 61‑year‑old male patient with advanced prostate cancer and bone marrow metastases was treated with olaparil after the ineffective effect of various anti‑tumor regimens.The patient had stable disease condition and was well tolerated to olaparib treatment.Five months later,the patient developed low‑grade fever,cough,chest tightness,and shortness of breath.Laboratory tests showed eosinophil count 0.85×10^(9)/L and eosinophil ratio 0.08.Chest CT scan revealed bronchitis in both lungs with inflammation in the upper lobe of left lung.After treatments of anti‑infection and tracheal dilation,the symptoms were not relieved,and chest CT re‑examination showed slightly enlarged and increased inflammation of left lung,interstitial inflammatory,and organizing pneumonia in both lungs.Alveolar lavage fluid cytology showed an elevation of eosinophils.Considering the possibility of olaparil‑induced eosinophilic pneumonia,olaparib was discontinued,and intravenous infusion of methylprednisolone 40 mg once daily and appropriate antiinfection therapy was given.After that,the patient did not have fever,and symptoms of cough,chest tightness,and shortness of breath were relieved.One week later,methylprednisolone was discontinued.Fever recurred and above respiratory symptoms were aggravated the next day.Methylprednisolone was re‑given.The patient did not have fever,and symptoms such as cough,chest tightness,and shortness of breath were relieved.After 7 days,the chest CT scan showed that the interstitial inflammation in lungs was obviously improved.

关 键 词：肺炎 嗜酸粒细胞 甲泼尼龙 奥拉帕利 

分 类 号：R969.3[医药卫生—药理学]