A case of drug-induced pneumonia followed by sequential bronchoalveolar lavage
Yoshinobu Fukui Raita Uchiyama Takeshi Hosokawa Etsuro Yamaguchi Eisei Jinushi Nobuyuki Hizawa Masaharu Nishimura
First Department of Medicine, Hokkaido University School of Medicine
A 30-year-old woman who had been receiving minocycline for 11 days to treat a skin burn presented with high fever and progressive dyspnea. Chest radiography demonstrated bilateral pulmonary infiltrates with ground glass opacities. She was admitted to our hospital under a tentative diagnosis of minocycline-induced pneumonia. Minocycline therapy was discontinued at hospital admission, which led to dramatic clinical and radiographic improvement. Bronchoalveolar lavage fluid (BALF) analysis three days after the onset of the pneumonia showed increased numbers of total cells (7.68× 105/ml), neutrophils (33%) and eosinophils (14%). An increased number of peripheral blood neutrophils was also noted at the time of hospital admission. Follow-up evaluations of BALF 10 days and 34 days after the onset showed rapidly declining numbers of neutrophils and eosinophils. We also measured the levels of several cytokines in BALF, suggesting that TNF-α and IL-8 contributed to the accumulation of neutrophils, whereas IL-5 contributed to the accumulation of eosinophils. In summary, we report here the temporal change in the inflammatory cell and cytokine profile in BALF, serum, or both, in a case of drug-induced pneumonia.
Drug-induced pneumonia Minocycline hydrochloride Serrapeptase Rebamipide Pulmonary neutrophilia
Received 平成15年9月10日
JJRS, 42(8): 743-748, 2004