{"created":"2021-03-01T06:12:23.869407+00:00","id":8383,"links":{},"metadata":{"_buckets":{"deposit":"5b855fa4-54e0-4cb9-8bc1-7795d833fad2"},"_deposit":{"id":"8383","owners":[],"pid":{"revision_id":0,"type":"depid","value":"8383"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00008383","sets":["453:456","471:537:538:892"]},"item_7_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"A Case of Drug - induced Pneumonitis due to Ougon and Saiko Involved inSai - rei - to - Showing Strong Uptake of Ga Scintigraphy"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2016-12","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"12","bibliographicPageEnd":"705","bibliographicPageStart":"699","bibliographicVolumeNumber":"130","bibliographic_titles":[{"bibliographic_title":"新潟医学会雑誌"},{"bibliographic_title":"新潟医学会雑誌","bibliographic_titleLang":"en"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は77歳の男性. 既往歴では白内障の手術を受け, その後当科受診の約2か月前より黄斑浮腫に対して柴苓湯を内服していた. 全身倦怠感, 咳嗽, 微熱を主訴に当科を初診. 血液検査でCRPの上昇, 肝機能障害があり, 血液ガスでは軽度の低酸素血症が認められた. 胸部レントゲンで両肺野に広くスリガラス状陰影がみられ, 胸部CTでは気管支血管に沿う形でスリガラス状の濃度上昇(Ground glass opacity; GGO)が認められ, 肺病変の精査のため, 当科入院となった. 薬剤性肺炎, 膠原病肺, 過敏性肺臓炎などが鑑別にあげられたが, 薬剤性肺炎をもっとも強く疑い, 降圧剤は数年前から内服しているため, 約2か月前より開始した柴苓湯が原因薬剤の可能性が高いものと考え, 眼科と相談のうえ, 内服を中止して経過観察した. 気管支肺胞洗浄(BAL), ガリウム(Ga)シンチグラフィーを施行し, BALではCD4/8の低下を伴うリンパ球優位の所見が得られ, Gaシンチグラフィーでは全肺野に著明な取り込み像が見られ, 薬剤性肺炎に矛盾しない結果が得られた. 肝機能障害, 血液ガスの改善を確認後退院し, 外来で経過観察. 膠原病, 過敏性肺臓炎は血液検査, 及び帰宅試験から否定された. その後胸部CTで改善を確認し, リンパ球幼弱化試験(DLST)にて柴苓湯の成分生薬であるオウゴンとサイコに陽性所見が得られ, 柴苓湯による薬剤性肺炎と診断した. これまでに11例の報告があるが, オウゴンとサイコのDLSTを施行した症例は本症例が初めての症例であり, これまでの報告例と比較検討したので, 報告する.","subitem_description_type":"Abstract"},{"subitem_description":"A 77-year-old man, who had been given Sai-rei-to since 2 months ago because of macular edema occurring after the operation of cataract, admitted our hospital complaining general fatigue, cough, and slight fever. Laboratory data showed the elevation of C-reactive protein and the liver injury. Chest X-ray and CT revealed ground – glass attenuation in both lung fields. Ga scintigram revealed the massive uptake in both lower lung fields. Bronchoalveolar lavage showed an increase of lymphocytes. According to these data, we suspected drug induced pneumonitis and liver injury. Discontinuance of Sai-rei-to recovered his condition, and lymphocyte-stimulation test was positive for Ougon and Saiko, involved in Sai-rei-to. Based on these results we diagnosed this case as Sai-rei-to –induced pneumonitis.","subitem_description_type":"Abstract"}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"58616","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Yamamoto, Takashi"}]},{"nameIdentifiers":[{"nameIdentifier":"58617","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Tsutsui, Nanako"}]},{"nameIdentifiers":[{"nameIdentifier":"58618","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Kazawa, Toshihiro"}]},{"nameIdentifiers":[{"nameIdentifier":"58619","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Sasagawa, Mayumi"}]},{"nameIdentifiers":[{"nameIdentifier":"58620","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Sato, Yayoi"}]}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会"}]},"item_7_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"publisher"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"00290440","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"山本, 尚"}],"nameIdentifiers":[{"nameIdentifier":"58611","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"筒井, 奈々子"}],"nameIdentifiers":[{"nameIdentifier":"58612","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"加澤, 敏広"}],"nameIdentifiers":[{"nameIdentifier":"58613","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"篠川, 真由美"}],"nameIdentifiers":[{"nameIdentifier":"58614","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"佐藤, 弥生"}],"nameIdentifiers":[{"nameIdentifier":"58615","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-06"}],"displaytype":"detail","filename":"130(12)_699-705.pdf","filesize":[{"value":"1.0 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"130(12)_699-705.pdf","url":"https://niigata-u.repo.nii.ac.jp/record/8383/files/130(12)_699-705.pdf"},"version_id":"a9addd76-7169-45fb-a7a3-c82bd2116a2e"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"柴苓湯","subitem_subject_scheme":"Other"},{"subitem_subject":"薬剤性肺炎","subitem_subject_scheme":"Other"},{"subitem_subject":"オウゴン","subitem_subject_scheme":"Other"},{"subitem_subject":"サイコ","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"Gaシンチグラムにて著明な取り込み像を呈し, オウゴンとサイコの関与が考えられた柴苓湯による薬剤性肺炎の1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"Gaシンチグラムにて著明な取り込み像を呈し, オウゴンとサイコの関与が考えられた柴苓湯による薬剤性肺炎の1例"},{"subitem_title":"Gaシンチグラムにて著明な取り込み像を呈し, オウゴンとサイコの関与が考えられた柴苓湯による薬剤性肺炎の1例","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","892"],"pubdate":{"attribute_name":"公開日","attribute_value":"2017-08-21"},"publish_date":"2017-08-21","publish_status":"0","recid":"8383","relation_version_is_last":true,"title":["Gaシンチグラムにて著明な取り込み像を呈し, オウゴンとサイコの関与が考えられた柴苓湯による薬剤性肺炎の1例"],"weko_creator_id":"1","weko_shared_id":null},"updated":"2022-12-15T03:42:42.365687+00:00"}