| Theme |
Complications of Respiratory Organs in Dialysis Patients |
| Title |
Drug-induced pneumonitis and lung disease associated with vasculitis |
| Author |
Masami Komeda |
Internal Medicine, Tokyo Women's Medical University Medical Center East |
| Author |
Takashi Naito |
Internal Medicine, Tokyo Women's Medical University Medical Center East |
| Author |
Madoka Satou |
Internal Medicine, Tokyo Women's Medical University Medical Center East |
| Author |
Youichi Ida |
Internal Medicine, Tokyo Women's Medical University Medical Center East |
| Author |
Chie Yamanaka |
Internal Medicine, Tokyo Women's Medical University Medical Center Eastl |
| Author |
Tsutomu Sanaka |
Internal Medicine, Tokyo Women's Medical University Medical Center East |
| [ Summary ] |
It is difficult to formulate a definite diagnosis of drug-induced pneumonitis even after performing a number of examinations. It is therefore important to suspect the presence of a causative drug and to investigate causative relationships through interviews and to follow the patient's clinical course. Early diagnosis and early treatment are required for proper treatment. In many cases, drug-induced pneumonitis is manifested as interstitial pneumonitis, which is usually treated with steroids and immunosuppressive agents. In some cases, there may be room for apheresis therapy intervention in addition to those drugs. In addition, the typical pulmonary manifestation of vasculitis is interstitial pneumonitis. However, pulmonary hemorrhaging may occur in association with vasculitis, resulting in a serious, life-threatening condition. Vasculitis-related pulmonary hemorrhaging is often observed in patients with microscopic polyangiitis (MPA), which is associated with myeloperoxidase-antineutrophil cytoplasmic antibodies (MPO -ANCA). Although MPO-ANCA-associated vasculitis is known to cause rapidly progressive glomerulonepliritis, the leading cause of death in patients with MPO-ANCA-associated vasculitis is infection, followed by pulmonary hemorrhaging and renal failure. MPO-ANCA-associated vasculitis is treated primarily with steroids and immunosuppressive agents, but apheresis therapy is concomitantly performed at many institutions. |