ゲムシタビン単剤投与により間質性肺炎を生じた膀胱癌

A cases of drug-induced interstitial pneumonitis after chemotherapy with gemcitabine for bladder cancer

症例は58歳，男性。2009年1月，膀胱タンポナーデとなり初診。精査にて膀胱癌，T2N1M1，多発性骨転移と診断。Gemcitabine単剤投与（1,000mg/m²）を開始した。3コース目施行中，発熱，咳嗽，炎症反応上昇。CTにて両肺野にスリガラス状陰影。LDH 347IU/l，肺surfactant protein D 285.8ng/ml。間質性肺炎と診断し，ステロイドパルス療法を施行した。

58-year-old man visited our hospital with complain of bladder tamponade. He was diagnosed bladder cancer T2N1M1 with multiple bone metastasis. Chemotherapy with gemcitabine（1,000 mg/m² on 1,8 and 15 every 4 weeks）was started. At three courses of chemotherapy,fever and respiratory symptoms emerged. Arterial blood gas analysis revealed severe hypoxemia. Chest X-ray and CT showed diffuse bilateral interstitial infiltrates. Steroid pulse therapy with 1,000 mg/day of methylprednisolone was started. His symptoms and radiolographical findings were improved after two weeks.