摘要
目的探讨药物相关性间质性肺疾病(DILD)的临床特点及误诊原因。方法回顾性分析2014年1月—2020年1月收治的4例误诊为其他疾病DILD的临床资料。结果本组误诊率为40%。4例均出现咳嗽、气短及喘息症状,2例查体可闻及爆裂音,1例出现发热;误诊为肺炎2例,心功能不全合并肺部感染及支气管哮喘各1例。4例均给予对症处理,患者症状无好转。经详细询问患者病史及用药史,完善胸部CT检查后考虑为DILD,其中胺碘酮引起的DILD 2例,奥卡西平、紫杉醇引起的DILD各1例。患者均停用相关药物,3例给予糖皮质激素治疗,1例对症观察。4例均症状改善,胸部影像学改变吸收。结论DILD临床不少见,临床医师要提高对该病的警惕性,熟知其影像学特点,拓宽诊断思维,从而避免或减少误诊。
Objective To investigate clinical characteristics and misdiagnosed causes of patients with drug-induced interstitial lung disease(DILD).Methods Clinical data of 4 DILD patients misdiagnosed as having other diseases admitted during January 2014 and January 2020 was retrospectively analyzed.Results The misdiagnosed rate was 40%.Cough,shortness of breath and gasping were found in the 4 patients,and inspiratory crackles were found in 2 patients,and fever was found in 1 patient.There were 2 patients misdiagnosed as having pneumonia,1 as having cardiac insufficiency combined with pulmonary infection and 1 as having bronchial asthma.The 4 patients received symptomatic treatments,but the patients'symptoms were not improved.After detailed inquiry of the patients'medical and medication histories,DILD was considered after chest CT examination.Among the 4 misdiagnosed patients,2 DILD patients were caused by Amiodarone,1 was by Oxcarbazepine and 1 was by Paclitaxel.All the patients stopped using related drugs,3 patients were given glucocorticoid treatment,and 1 was observed.The 4 patients'symptoms were improved,and chest imaging examinations showed changes and absorption.Conclusion DILD is common in clinic.Clinicians should improve their vigilance to the diseases,familiarize themselves with their imaging characteristics and broaden their diagnostic thinking in order to avoid or reduce misdiagnosis.
作者
李秀业
杨霁
赵惠敏
LI Xiu-ye;YANG Ji;ZHAO Hui-min(Department of Respiratory Medicine,Beijing Chuiyangliu Hospital,Beijing 100022,China)
出处
《临床误诊误治》
CAS
2021年第6期5-9,共5页
Clinical Misdiagnosis & Mistherapy
关键词
药物相关性间质性肺疾病
误诊
肺炎
哮喘
胺碘酮
奥卡西平
紫杉醇
Drug-induced interstitial lung diseases
Misdiagnosis
Pneumonia
Asthma
Amiodarone
Oxcarbazepine
Paclitaxel
