A Case of Diffuse Alveolar Damage Induced by Cyclophosphamide

Cyclophosphamide에 의해 유발된 미만성 폐포 손상 1예

Approximately 100 drugs have been reported to affect the lungs adversely. Among these, pulmonary toxicity caused by antieneoplastic agent. is being recognized more frequently. Cyclophosphamide is an immunosuppressive alkylating agent used for the treatment of a wide variety of malignant and nonmalignant diseases. The incidence of pulmonary toxicity is probably less than 1 percent The first case was reported in 1967. Since then, more than 20 well-documented cases of pulmonary toxicity associated with cyclophosphamide have been reported in the literature. In Korea, three patients were identified with cyclophosphamide-induced lung disease. The typical features of toxicity include dyspnea, fever, cough, new parenchymal infiltrates, gas exchangs abnormalities on pulmonary function tests, and pleural thickening on chest roentgenogram. The best approach to management is early diagnosis, discontinuation of the offending drug and administration of corticosteroid therapy. Recently, we experienced a case of diffuse alveolar damage induced by cyclophosphamide. The patient presented with early-onset pulmonary toxicity and died of repiratory failure despite early use of corticosteroid.

저지들은 이전의 문헌과 비슷하게 만성 특발성 혈소판 감소증 환자에서 cyclophosphamide와 스테로이드 치료도중 cyclo-phosphamide 최초 투여 시작일로부터 1~2개월이내에 발생한 조기 발현형 폐독성으로 개흉폐생검을 통하여 진단한 후 조기에 cyclophosphamide의 투여 중단과 함께 스테로이드 사용에도 불구하고 진행성 호흡부전으로 사망한 환자를 경험하였기에 이틀 문헌고찰과 함께 보고하는 바이다.