Azithromycin 투여로 폐기능이 호전된 폐쇄성 세기관지염 1예
Improvement of Pulmonary Function after Administration of Azithromycin in a Patient with Bronchiolitis Obliterans: a Case Report
김성우 (대구가톨릭대학교)
현대성 (대구가톨릭대학교)
이상채 (대구가톨릭대학교)
배성화 (대구가톨릭대학교)
정경재 (대구가톨릭대학교)
권건영 (계명대학교)
김경찬 (대구가톨릭대학교 의과대학)
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초록
폐쇄성 세기관지염은 골수 이식 후 폐에 발생하는 합병증이다. 현재 스테로이드와 면역 억제제를 투여하여 적극적인 치료를 하더라도 폐기능의 호전을 보이는 경우는 일부에 불과하다. 저자들은 기존의 치료에도 불구하고 호전을 보이지 않은 골수 이식 후 발생한 폐쇄성 세기관지염 환자에서macrolide계 항생제인 azithromycin을 1년간 경구 투여하여 폐기능이 호전됨을 경험하였기에 문헌고찰과 함께 보고하는 바이다.
- keywords
- Bone marrow transplantation, Bronchiolitis obliterans, Pulmonary function, Azithromycin
Abstract
Bronchiolitis obliterans (BO) is a serious noninfectious complication following an allogeneic bone marrow transplant (BMT). A 21-year-old female received an allogeneic BMT as a treatment for myelodyplastic syndrome. Four months after the BMT, progressive dyspnea developed and BO was also diagnosed by a lung biopsy. The patient was administered steroid and immunosuppressive agents for 1 year but there was no improvement in pulmonary function. Azithromycin was prescribed (500 mg q.d. for 3 days followed by 250 mg three time a week) because macrolides might decrease the inflammatory reaction leading to BO. The patient’s pulmonary function improved after administration of azithromycin for 1 year. The forced expiratory volume in a one second (FEV1) increase was 220 mL (28.2%) and the forced vital capacity (FVC) increase was 460 mL (25.7%). We report the improvement in the pulmonary function after the administration of azithromycin for 1 year in a patient with BO after a BMT.
- keywords
- Bone marrow transplantation, Bronchiolitis obliterans, Pulmonary function, Azithromycin
참고문헌
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