DOI QR코드

DOI QR Code

류마티스 관절염 환자에서 종양괴사인자 억제제 사용 중 발생한 미만성 폐포 출혈 1예

Diffuse Alveolar Hemorrhage after Adalimumab Treatment of Rheumatoid Arthritis

  • 김혜진 (순천향대학교 의과대학 내과학교실) ;
  • 조홍성 (조선대학교 의과대학 내과학교실) ;
  • 김윤성 (조선대학교 의과대학 내과학교실) ;
  • 김현숙 (순천향대학교 의과대학 내과학교실)
  • Kim, Hye Jin (Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Chough, Hong-Sung (Department of Internal Medicine, Chosun University College of Medicine) ;
  • Kim, Yun Sung (Department of Internal Medicine, Chosun University College of Medicine) ;
  • Kim, Hyun-Sook (Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • 투고 : 2013.04.02
  • 심사 : 2013.05.15
  • 발행 : 2013.10.01

초록

RA 치료로 쓰이는 종양괴사인자 억제제의 안정성 및 효용성은 이미 입증되었으나 임상에서 약제 사용과 관련한 심각한 부작용을 염두에 두어야 한다. 저자들은 종양괴사인자 억제제, adalimumab 사용과 관련한 DAH를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.

Diffuse alveolar hemorrhage (DAH) is a life-threatening condition involving hemorrhage originating in the pulmonary microvasculature. The clinical syndrome is characterized by hemoptysis, hypoxemic respiratory failure, low-grade fever, and diffuse pulmonary infiltrates. The majority of cases of DAH are caused by pulmonary renal syndromes, connective tissue disorders, and drugs. Here, we present a case of DAH associated with adalimumab treatment in a patient with rheumatoid arthritis.

키워드

참고문헌

  1. Song JS. Review of tumor necrosis factor inhibitors on rheumatoid arthritis. J Korean Rheum Assoc 2007;14:1-14. https://doi.org/10.4078/jkra.2007.14.1.1
  2. Newsome BR, Morales JE. Diffuse alveolar hemorrhage. South Med J 2011;104:269-274. https://doi.org/10.1097/SMJ.0b013e3182126d3b
  3. Traclet J, Lazor R, Cordier JF, Cottin V. Alveolar hemorrhage. Rev Med Interne 2012;34:214-223.
  4. West S, Arulkumaran N, Ind PW, Pusey CD. Diffuse alveolar haemorrhage in ANCA-associated vasculitis. Intern Med 2013;52:5-13. https://doi.org/10.2169/internalmedicine.52.8863
  5. Schwarz MI, Fontenot AP. Drug-induced diffuse alveolar hemorrhage syndromes and vasculitis. Clin Chest Med 2004;25:133-140. https://doi.org/10.1016/S0272-5231(03)00139-4
  6. Panagi S, Palka W, Korelitz BI, Taskin M, Lessnau KD. Diffuse alveolar hemorrhage after infliximab treatment of Crohn's disease. Inflamm Bowel Dis 2004;10:274-277. https://doi.org/10.1097/00054725-200405000-00016
  7. Jeannin G, Mathieu S, Kemeny JL, Caillaud D, Soubrier M. Alveolar hemorrhage after infliximab therapy. Joint Bone Spine 2010;77:189-190. https://doi.org/10.1016/j.jbspin.2009.12.007
  8. Khaja M, Menon L, Niazi M, Fuentes GD. Diffuse alveolar hemorrhage and acute respiratory distress syndrome during treatment of rheumatoid arthritis with etanercept. J Bronchology Interv Pulmonol 2012;19:228-231. https://doi.org/10.1097/LBR.0b013e3182608e01
  9. Carloni A, Piciucchi S, Giannakakis K, Nori G, Zobel BB, Poletti V. Diffuse alveolar hemorrhage after leflunomide therapy in a patient with rheumatoid arthritis. J Thorac Imaging 2008;23:57-59. https://doi.org/10.1097/RTI.0b013e3181598d40
  10. Hemmati I, Kur J. Adalimumab-associated antiphospholipid syndrome: a case report and review of the literature. Clin Rheumatol 2013;32:1095-1098. https://doi.org/10.1007/s10067-013-2244-0