title: [A case of pulmonary alveolar hemorrhage caused by methylergometrine].
abstract: 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.
authors.affiliation: Department of Respiratory Medicine, Toho University Omori Medical Center.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Isobe
authors.forename: Motohide
authors.initials: M
authors.lastname: Iwata
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Ishida
authors.forename: Kyohei
authors.initials: K
authors.lastname: Kaburaki
authors.forename: Kyoko
authors.initials: K
authors.lastname: Gocho
authors.forename: Yoko
authors.initials: Y
authors.lastname: Muramatu
authors.forename: Shinji
authors.initials: S
authors.lastname: Sakaguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Satou
authors.forename: Go
authors.initials: G
authors.lastname: Sano
authors.forename: Emiko
authors.initials: E
authors.lastname: Kusano
authors.forename: Susumu
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Takai
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Shibuya
authors.forename: Sakae
authors.initials: S
authors.lastname: Homma
mesh_terms: D000022:Abortion, Spontaneous / Q000188:drug therapy; D000328:Adult; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced*; D008755:Methylergonovine / Q000009:adverse effects*; D010120:Oxytocics / Q000009:adverse effects*; D011650:Pulmonary Alveoli
chemical_list: D010120:Oxytocics; D008755:Methylergonovine