A Case of Catamenial Hemoptysis treated successfully with Gonadotropin-releasing Hormone (GnRH) Analogue

Gonadotropin-releasing Hormone (GnRH) Analogue로 치유된 Catamenial Hemoptysis 1예

Catamenial hemoptysis is syndrome characterized by bleeding from the bronchial trees and lungs that occurs synchronously with the female menstrual cycle. Etiologic mechanism of pulmonary endometriosis is still controversial, and the diagnosis is usually made on the basis of the clinical history and exclusion of other causes of recurrent hemoptysis. Serial computed tomograms of the chest during and in the interval between menstruations have been proved to be a useful confirmatory test. We experienced a 33-year-old female patient who had been previously diagnosed as pelvic endometriosis pathologically, experienced cyclic hemoptysis during menstruations. The diagnosis of pulmonary endometriosis was made based on her history and changes in the character of the lesions as documented on radiologic studies of the chest. She was treated successfully with GnRH analogue and there is no evidence of recurrence.

여러 국내외 논문에서 hormone 치료는 우수한 효과를 나타내었으나 치료 종료 후 객혈이 다시 발생하여 추가적인 수술을 받는 경우가 많았으며, GnRH analogue의 장점에도 불구하고 hormone 치료로 완치된 예는 대부분 danazol에 의한 경우가 많았다. 저자들이 경험한 환자는 월경과 동반된 객혈, 월경주기에 따라 변하는 방사선학전 변화와 GnRH analogue 치료에 대한 극적인 증상의 호전 등의 전형적인 소견으로 폐실질 자궁내막증에 의한 catamenial hemoptysis로 진단되었다. 6회의 hormone 치료 기간동안 임상양상의 호전을 보였고, 치료를 중단한 후에도 재발의 증거가 없는 상태로 외래를 다니고 있다.