[Pulmonary infiltrates with blood eosinophilia in a 62-year-old patient].
A 62-year-old woman was admitted because of chronic cough and bilateral infiltrates on chest roentgenogram. Additional history revealed that the patient had been taken diclofenac emulgel during the previous 10 years for arthrosis. Diagnostic bronchoscopy showed eosinophilic alveolitis. After ruling out infectious, parasitic or systemic diseases drug-induced eosinophilic pneumonia was diagnosed due to topical diclofenac therapy and subsequent percutaneous drug absorption. No previous case of eosinophilic pneumonia to topical diclofenac was discovered in our review of the literature. The diclofenac therapy was discontinued. Oral corticosteroid therapy cleared bilateral infiltrates on CT scan within seven days. Drug reactions are the most common cause of pulmonary infiltrates with blood eosinophilia and/or eosinophilic alveolitis and should be considered as a differential diagnosis.
Kohlhäufl
M
M
Zentrum für Pneumologie und Thoraxchirurgie, Asklepios Fachklinik München-Gauting. m.kohlhaeufl@asklepios.com
Weber
N
N
Morresi-Hauf
A
A
Geiger
D
D
Raith
H
H
Häussinger
K
K
D000287:Administration, Topical; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D002908:Chronic Disease; D003371:Cough / Q000209:etiology*; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D004802:Eosinophilia / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy; D011657:Pulmonary Eosinophilia / Q000139:chemically induced*; D020069:Shoulder Pain / Q000188:drug therapy
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac