来氟米特致间质性肺炎3例并文献复习

Three cases of leflunomide induced pneumonitis and literature review

目的探讨来氟米特致间质性肺炎（LEIP）的临床特征，提高对LEIP的认识和临床诊治水平。方法回顾性分析我院3例LEIP患者的临床特点，并结合文献复习。结果本组患者均在接受来氟米特治疗约20周内发病。症状为进行性发展的咳嗽、呼吸困难，胸部CT表现为双肺弥漫性磨玻璃样改变和纤维条索网状影。经呼吸机辅助通气和糖皮质激素等治疗后，2例患者好转，1例患者死亡。结论间质性肺炎是来氟米特导致的少见却严重的并发症，应该给予高度的重视。

Objective To investigate the clinical feature of leflunomide induced pneumonitis （LEIP） ,and enhance the recognition and level of clinical diagnosis and treatment of LEIP. Methods The clinical data of three cases of LEIP were retrospectively analyzed,and relevant literatures were reviewed. Results All the three patients had LEIP within the first 20 weeks after receiving leflunomide, with the symptom of progressive cough and dyspnea. Chest CT showed diffuse ground glass-like changes and fiber cord reticular shadow in lung. After treated by mechanical ventilation and glucocorticosteroid, two patients improved,and one patient died. Conclusions LEIP is a rare and serious complication,which should be paid close attention to.