Mycophenolate mofetil and bronchiectasis in kidney transplant patients: a possible relationship.
Mycophenolate mofetil and bronchiectasis in kidney transplant patients: a possible relationship.
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吗替麦考酚酯和肾移植患者的支气管扩张：可能的关系。
DOI：
10.1097/01.tp.0000188638.28003.96
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发表时间：
2006
期刊：
影响因子：
6.2
通讯作者：
W. V. van Son
中科院分区：
文献类型：
--
作者：
M. Rook;D. Postma;E. J. van der Jagt;C. A. van Minnen;J. J. H. van der Heide;R. Ploeg;W. V. van Son
支气管扩张症是一种罕见的后天性疾病，通常由长期慢性肺部炎症引起。吗替麦考酚酯（简称吗替麦考酚酯）是肾移植中常用的免疫抑制剂。在文献中，没有关于使用莫非替与支气管扩张发展之间关系的报道。五名肾移植患者出现咳嗽、呼吸困难和无明显原因的大量痰液。肺部主诉开始于莫非替治疗开始后0-20个月。根据临床表现、胸部X线和计算机断层扫描，病变被归类为支气管扩张（样）。停用莫非替可大大缓解肺部不适。自1968年我们中心进行第一例肾移植以来，我们在1,500多例未经莫非替治疗的患者中没有诊断出支气管扩张。这些病例提示莫非替与支气管扩张的发生有关。当接受莫非替的患者出现不明原因的肺部不适时，应考虑将莫非替转换为另一种免疫抑制药物。
Bronchiectasis is a rare acquired condition, generally resulting from long-term chronic pulmonary inflammation. Mycophenolate mofetil (in short, mofetil) is a commonly used immunosuppressant in kidney transplantation. In the literature, there is no report of a relationship between mofetil use and development of bronchiectasis. Five kidney transplant patients developed complaints of cough, dyspnea, and abundant sputum production without apparent cause. Pulmonary complaints started at a range of 0-20 months after the start of mofetil treatment. Lesions were classified as bronchiectasis(-like), based on clinical presentation, chest x-ray, and computed tomography scan. Withdrawal of mofetil greatly relieved pulmonary complaints. Since the first kidney transplantation in our center in 1968, we have had no diagnosis of bronchiectasis in over 1,500 patients without mofetil treatment. These cases suggest an association between mofetil and development of bronchiectasis. Converting mofetil to another immunosuppressive drug should be considered when unexplained pulmonary complaints develop in patients receiving mofetil.