著者

野村 将春 藤村 政樹 松田 保 北川 正信

出版者

The Japanese Respiratory Society

雑誌

日本胸部疾患学会雑誌 (ISSN:03011542)

巻号頁・発行日

vol.35, no.1, pp.72-76, 1997-01-25 (Released:2010-02-23)

参考文献数

16

---

症例は75歳男性, 以前より風邪症状があると市販の総合感冒薬 (パブロンS®) を常用していた. 入院6日前より風邪症状を認め, パブロンS®を内服していたが, なくなったので, 新しい総合感冒薬 (パブロンゴールド®)を内服した. その翌日より呼吸困難出現, 近医にて胸部レントゲン写真上, 両側にびまん性陰影を認めたため, 精査目的で当科に紹介された. 胸部CTでは両側に間質性陰影が認められた. 気管支肺胞洗浄液中には好中球, リンパ球などの炎症細胞が認められた. 経気管支肺生検では肥厚した肺胞壁や間質への単核球の浸潤が認められた. 末梢血のリンパ球を用いた薬剤リンパ球刺激試験ではパブロンゴールド®が陽性であった. 以上よりパブロンゴールド®による薬剤性肺炎と診断した. 入院後, ステロイドを投与したところ症状は速やかに改善したが陰影は遷延した.

著者

山崎 義亀与 松田 保 黒田 満彦 内田 健三 嶋田 千恵子 大谷 逸子 村上 元孝 北川 正信

出版者

一般社団法人 日本血液学会

雑誌

臨床血液 (ISSN:04851439)

巻号頁・発行日

vol.14, no.1, pp.81-87, 1973

---

A 25-year-old male was admitted because of dark-red urine, jaundice and purpura. 5 days prior to admission, the patient noticed that the urine color became dark red, and purpuric rash and jaundice were noted by his wife.<br>Examination revealed scleral icterus, pallor, numerous petechiae and an ecchymosis. The sensorium was clear. The neurologic examination was normal.<br>The patient had hemolytic anemia, thrombocytopenic purpura, fever and proteinuria. Shortly after admission, fluctuating neurologic symptoms developed, and the patient was diagnosed as thrombotic thrombocytopenic purpura.<br>He was treated with prednisolone and heparin without benefits, and expired on the 14 th hospital day.<br>Hyaline thromboses of the vessels of liver and kidney were demonstrated by the examination of the specimens obtained by post mortem needle puncture.<br>Coagulation studies disclosed that partial thromboplastin time and prothrombin time were slightly prolonged, however, factor V activity and fibrinogen titre were not low. Fibrinogen degradation products determined by tanned red cell hemagglutination inhibition immunoassay were markedly increased, although euglobulin lysis time was not shortened.<br>Immunological analysis of serum proteins showed the increase of acute phase reactants, the decrease of &beta;₁-AC and haptoglobin, and the appearance of fibrinogen degradation products.<br>These results were discussed in relation to the pathogenesis of the disease.