[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: Kazutoshi Isobe, Motohide Iwata, Fumiaki Ishida, Kyohei Kaburaki, Kyoko Gocho, Yoko Muramatu, Shinji Sakaguchi, Daisuke Satou, Go Sano, Emiko Kusano, Susumu Sakamoto, Yujiro Takai, Kazutoshi Shibuya, Sakae Homma
• Journal: Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society (Nihon Kokyuki Gakkai Zasshi) Vol. 46 Issue 12 Pg. 1007-12 (Dec 2008) ISSN: 1343-3490 [Print] Japan
• PMID: 19195202 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Oxytocics
• Methylergonovine

Topics

• Abortion, Spontaneous (drug therapy)
• Adult
• Female
• Hemorrhage (chemically induced)
• Humans
• Lung Diseases (chemically induced)
• Methylergonovine (adverse effects)
• Oxytocics (adverse effects)
• Pulmonary Alveoli