The Korean Journal of Medicine

  • 제93권6호
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  • Pages.571-574
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  • 2018
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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니볼루맙 치료 도중 발생한 폐포자충 폐렴 1예

Pneumocystis Pneumonia Developing during Treatment of Recurrent Renal Cell Cancer with Nivolumab

  • Kim, Hak Ro (Division of Hematology and Oncology, Department of Internal Medicine, Pohang Semyeong Christianity Hospital) ;
  • Keam, Bhumsuk (Department of Internal Medicine, Seoul National University Hospital) ;
  • Park, Young Sik (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Miso (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Tae Min (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Dong-Wan (Department of Internal Medicine, Seoul National University Hospital) ;
  • Heo, Dae Seog (Department of Internal Medicine, Seoul National University Hospital)
  • 투고 : 2017.12.01
  • 심사 : 2018.02.21
  • 발행 : 2018.12.01
⟨ 이전 논문 다음 논문 ⟩

초록

니볼루맙을 사용하는 도중 폐렴이 발생할 수 있고, 폐렴이 의심되면 치료하기 이전에 바이러스를 포함한 감염 여부와 림프관성 암의 진행 상태 및 울혈성 심장 기능 상실 여부 등의 감별이 필요하며 폐렴의 등급과 중증도를 평가하여 스테로이드를 경험적으로 쓰는 것이 중요하다. 본 증례에서는 감염을 배제하기 위하여 기관지 폐포세척을 시행한 후 폐포자충 폐렴이 진단된 사례로 드물기는 하지만 페포자충 폐렴의 감별이 필요함을 보여주어 증례로 보고하는 바이다.

Nivolumab is an immune checkpoint inhibitor approved for the treatment of metastatic cancers. Here, we report the case of a 65-year-old male with recurrent renal cell carcinoma. After six cycles of nivolumab treatment, positron emission tomography/computed tomography (PET/CT) was performed to evaluate the response. PET/CT revealed diffuse ground glass opacities in both lungs. He developed a cough, sputum, chills, and a febrile sense. After bronchoscopic bronchoalveolar lavage, pneumocystis pneumonia was finally diagnosed.

키워드

참고문헌

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