Dantrolene and pleural effusion: case report and review of literature.
METHODS
Single-subject case (a quadriplegic female, 56 years).


OBJECTIVE
To describe a new case of eosinophilic pleural effusion induced by dantrolene chronic administration.


METHODS
Physical medicine and rehabilitation unit in a teaching hospital, France.


METHODS
Diagnosis of an eosinophilic pleural effusion induced by dantrolene without any respiratory symptoms, except a decrease of breath sounds on the right lung base.


RESULTS
Chest radiograph revealed a right-sided pleural effusion, and blood cell count a significant peripheral eosinophilia. Thoracenthesis contained 85% of eosinophils. The other explorations eliminated other causes of pleural effusion. The diagnosis of drug-induced effusion was almost sure and led us to discontinue the dantrolene. After 3 months, she had completely recovered. These characteristics, similar to the eight other cases described in the literature, are essential for the diagnosis of pleural effusion induced by dantrolene.


CONCLUSIONS
Dantrolene, a long-acting skeletal muscle relaxant, is well known to induce liver side effects but it can also induce pleural pericarditis. The pathogenesis is still not clearly identified, but similarities of chemical structures of dantrolene and nitrofurantoine make us think that it could be the same mechanism. The association between dantrolene and nitrofurantoine may have contributed to the expression of the pleural effusion.
Lê-Quang
B
B
1Service de Médecine Physique et de Réadaptation, Hôpital Bellevue, CHU de Saint-Etienne, Saint-Etienne, France.
Calmels
P
P
Valayer-Chaléat
E
E
Fayolle-Minon
I
I
Gautheron
V
V
D003620:Dantrolene / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000009:adverse effects*; D018482:Muscle, Skeletal / Q000187:drug effects / Q000503:physiopathology; D009582:Nitrofurantoin / Q000009:adverse effects; D010994:Pleura / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D010996:Pleural Effusion / Q000139:chemically induced* / Q000276:immunology / Q000503:physiopathology; D011657:Pulmonary Eosinophilia / Q000139:chemically induced* / Q000276:immunology / Q000503:physiopathology; D011782:Quadriplegia / Q000150:complications / Q000188:drug therapy; D011859:Radiography; D013119:Spinal Cord Injuries / Q000150:complications
D009125:Muscle Relaxants, Central; D009582:Nitrofurantoin; D003620:Dantrolene