[缬沙坦致肺炎血清KL-6明显升高1例]。

Akira Takakura, Masaru Kubota, Sakiko Otani, Ken Katono, Michiko Yamamoto, Noriyuki Masuda
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引用次数: 0

摘要

一名64岁男性,约2个月前接受缬沙坦治疗高血压,因用力性呼吸困难入院。入院时胸部x线片示双侧下肺野浸润影。胸部计算机断层图像显示弥漫性磨玻璃影,实变和牵引性支气管扩张。血清KL-6水平明显升高,达到7360 U/ml。尽管停药缬沙坦,他的症状恶化,药物淋巴细胞刺激试验缬沙坦阳性。基于这些发现,我们诊断为缬沙坦引起的肺炎。给予糖皮质激素治疗后,患者的症状、胸片表现和血清KL-6水平均有所改善。目前,血管紧张素II受体阻滞剂(ARBs),包括缬沙坦,通常被用作治疗高血压的首选药物,但它们可引起药物性肺炎。此前有报道称,血清KL-6水平可能反映药物性肺炎的临床活动性。在血清KL-6水平较高的药物性肺炎病例中,糖皮质激素应在早期开始使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A case of valsartan-induced pneumonitis with marked elevation of serum KL-6].

A 64-year-old man, who had been treated with valsartan for hypertension since about 2 months previously, was admitted with exertional dyspnea. A chest X-ray film on admission showed infiltrative shadows in bilateral lower lung fields. Chest computed tomographic images showed diffuse ground-glass opacities, consolidation and traction bronchiectasis. His serum KL-6 level was markedly elevated, to 7,360 U/ml. Despite the withdrawal of valsartan, his symptoms deteriorated, and a drug lymphocyte stimulation test was positive for valsartan. Based on these findings, we diagnosed valsartan-induced pneumonitis. Glucocorticoids were administered, and his symptoms, chest radiograph findings and serum KL-6 level all improved. Currently, angiotensin II receptor blockers (ARBs), including valsartan, are often used as the first drug of choice to treat hypertension, but they can cause drug-induced pneumonitis. It has been previously reported that serum KL-6 levels may reflect the clinical activity of drug-induced pneumonitis. In cases of drug-induced pneumonitis with a high level of serum KL-6, glucocorticolds should be started at an early stage.

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