Gefitinib-Related Interstitial Lung Disease with Pleural Effusion Successfully Treated with Medium Dose of Steroid: A Case Report and Literature Review

經中劑量類固醇成功治療的艾瑞莎再激發引起之間質性肺炎併肋膜積水：病例報告與文獻回顧

林書帆(Shu-Fan Lin) ； 林明泰(Ming-Tai Lin) ； 林慶雄(Ching-Hsing Lin)

《胸腔醫學》 29卷1期 (2014/02) Pp. 25-31

摘要

艾瑞莎是種有效治療非小細胞肺癌的表皮生長因子酪氨酸激酶抑制劑。然而，此藥物仍有可能產生如間質性肺炎等嚴重的種副作用。我們提出一個肺癌的案例，一開始無法明確診斷是治療過程中發生非典型肺炎還是艾瑞莎所引起的菅直性肺炎合併肋膜積水，經由再次使用艾瑞莎導致間質性肺炎亦合併肋膜積水，進而確診此病例為艾瑞莎引起之間質性肺炎及肋膜積水。

關鍵字

艾瑞莎 ； 肺腺癌 ； 間質性肺炎 ； 肋膜積水

並列摘要

Gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor, is effective for patients with non-small cell lung cancer. However, the serious adverse effect of interstitial lung disease has been reported with its use. We present the case of a patient with lung adenocarcinoma with re-challenge gefitinib-induced interstitial lung disease with pleural effusion. The patient was then initially treated for atypical pneumonia and gefitinib was stopped, however re-administration of gefitinib led to the same symptoms re-occurring. The patient recovered from the interstitial lung disease with pleural effusion after steroid therapy. Re-administration of gefitinib should be considered cautiously in patients who have previously developed gefitinib-induced interstitial lung disease.

並列關鍵字

gefitinib ； lung adenocarcinoma ； interstitial lung disease ； pleural effusion