比卡鲁胺致间质性肺炎

Interstitial pneumonia induced by bicalutamide

1例72岁男性患者因前列腺癌伴多发骨转移给予比卡鲁胺(50 mg口服、1次/d)+注射用醋酸亮丙瑞林缓释微球(3.75 mg皮下注射、1次/4周)内分泌治疗,以及唑来磷酸注射液(4 mg入0.9%氯化钠注射液100 ml静脉滴注、1次/4周)治疗骨痛。9个多月后,患者出现气促、继而发热,经肺部CT检查诊断为肺炎。给予抗感染治疗,患者症状未改善。呼吸科医师考虑患者为比卡鲁胺致间质性肺炎。停用该药并给予甲泼尼龙(首次剂量240 mg,症状好转后逐渐减量)治疗后,患者症状改善,胸部X线检查示肺部炎症范围缩小。

A 72-year-old male patient received endocrine therapy with oral bicalutamide (50 mg, once daily) and subcutaneous injection of leuprorelin acetate microspheres sustained release for injection (3.75 mg, once per 4 weeks) as well as treatment for bone pain with IV infusion of zoledronic acid injection (4 mg once per 4 weeks, added into 100 ml of 0.9% sodium chloride injection) for prostate cancer with multiple bone metastases. After more than 9 months of treatments, the patient developed dyspnea and then fever. He was diagnosed as having pneumonia through CT examination of the lungs. The patient′s symptoms did not improve after anti-infective treatments. The respiratory physician considered the patient to have interstitial pneumonia caused by bicalutamide. The drug was discontinued, and methylprednisolone (the initial dose was 240 mg, which was gradually reduced after the symptoms improved) was given. The patient′s symptoms improved, and the chest X-ray examination showed that the lung inflammation was reduced.