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Article in Japanese
A case of pulmonary alveolar hemorrhage caused by methylergometrine
Kazutoshi Isobe1) Motohide Iwata1) Fumiaki Ishida1) Kyohei Kaburaki1) Kyoko Gocho1) Yoko Muramatu1) Shinji Sakaguchi1) Daisuke Satou1) Go Sano1) Emiko Kusano1) Susumu Sakamoto1) Yujiro Takai1) Kazutoshi Shibuya2) Sakae Homma1)
1)Department of Respiratory Medicine, 2)Department of Pathology, Toho University Omori Medical Center
A 35-year-old woman underwent endometrial curettage for suspicion of miscarriage. A few minutes after intravenous injection of methylergometrin (0.2 mg) for inducing uterine contraction, blood gas analysis revealed severe hypoxemia. Chest CT showed diffuse ground-glass opacities in both lung fields and consolidation in the right lower lobe. Bronchoscopy revealed blood coagulation in the right bronchus intermedius. Bronchoalveolar lavage fluid showed fresh blood-like fluid containing hemosiderin-laden macrophages. We diagnosed pulmonary alveolar hemorrhage associated with pulmonary edema. Although we analyzed the possible causes of alveolar hemorrhage such as pulmonary thromboembolism, collagen disease, ANCA-related angitis and malignant disease, there were no underlying systemic diseases. It seems likely that contraction of the blood vessels caused by methylergometrin caused the increased pulmonary arterial and wedge pressure which led to pulmonary edema and alveolar hemorrhage. We believe this is the first reported case of pulmonary alveolar hemorrhage caused by methylergometrin, confirmed by bronchoscopy.
Methylergometrine Pulmonary alveolar hemorrhage Pulmonary edema Missed abortion
Received 平成20年5月2日
JJRS, 46(12): 1007-1012, 2008