초록접수 현황
| 14F-027 | 포스터 발표 |
Acute Pneumonitis Resulting from Pleurodesis with Viscum Album Extract: Grave Image with Benign Clinical Course
김수완, 장지원, 이석재, 장지원
제주대학교 의학전문대학원 흉부외과학교실
Background : Chemical pleurodesis is widely recommended in the treatment of pulmonary air leak of different etiologies as well as malignant pleural effusions and chylothorax. Conventional chemical pleurodesis using erythromycin, tetracycline, hydrophilic fumed silica, autologous blood and talc slurry has been standardized, and its complications, including high fever, intractable chest pain, and acute lung injury, seem to be frequent.
Methods : ABNOBA viscum F is an extract of Viscum album (European mistletoe), which grows on trees of the genus Fraxinus. This extract is the most frequently prescribed drug for complementary treatment in cancer patients in several European countries. Viscum album extract is a new chemical agent for pleurodesis, and only a few studies have reported outcomes of chemical pleurodesis in the treatment of malignant pleural effusion. Moreover, the complications resulting from pleurodesis using Viscum album extract are very rare, and acute pneumonitis has not been reported. We report the first case of acute pneumonitis after pleurodesis using Viscum album extract in a 58-year-old man who had prolonged air leaks after a left upper lingular segmentectomy for metastatic lung cancer (A). We performed repeated pleurodesis four times with 2 to 4 days intervals. While the patient had no symptoms of pneumonia, such as cough, sputum, chilling, and fatigue, a follow-up chest X-ray revealed increasing peribronchial consolidations and infiltrations in the left upper lobe (B). A chest tomography showed extensive parenchymal consolidations and ground-glass appearances in the left lungs, representing pneumonia with acute lung injury (C).
Results : The acute pneumonitis was spontaneously resolved with supportive care, and the patient was discharged ten days after the development of pneumonitis (D).
Conclusion : We propose that when repeated pleurodesis is mandatory, pleurodesis with Viscum album extract should be performed with careful attention and enough intervals over one week. Although an acute pneumonitis occurs, it can be spontaneously and quickly resolved with supportive care.
Methods : ABNOBA viscum F is an extract of Viscum album (European mistletoe), which grows on trees of the genus Fraxinus. This extract is the most frequently prescribed drug for complementary treatment in cancer patients in several European countries. Viscum album extract is a new chemical agent for pleurodesis, and only a few studies have reported outcomes of chemical pleurodesis in the treatment of malignant pleural effusion. Moreover, the complications resulting from pleurodesis using Viscum album extract are very rare, and acute pneumonitis has not been reported. We report the first case of acute pneumonitis after pleurodesis using Viscum album extract in a 58-year-old man who had prolonged air leaks after a left upper lingular segmentectomy for metastatic lung cancer (A). We performed repeated pleurodesis four times with 2 to 4 days intervals. While the patient had no symptoms of pneumonia, such as cough, sputum, chilling, and fatigue, a follow-up chest X-ray revealed increasing peribronchial consolidations and infiltrations in the left upper lobe (B). A chest tomography showed extensive parenchymal consolidations and ground-glass appearances in the left lungs, representing pneumonia with acute lung injury (C).
Results : The acute pneumonitis was spontaneously resolved with supportive care, and the patient was discharged ten days after the development of pneumonitis (D).
Conclusion : We propose that when repeated pleurodesis is mandatory, pleurodesis with Viscum album extract should be performed with careful attention and enough intervals over one week. Although an acute pneumonitis occurs, it can be spontaneously and quickly resolved with supportive care.
책임저자: 장지원
제주대학교 의학전문대학원 흉부외과학교실
연락처 : 김수완, Tel: 064-753-8125 , E-mail : 95swan@gmail.com
