[A case of drug-induced pneumonitis due to bepridil].
A 66-year-old man had been given bepridil for the treatment of atrial fibrillation since April 28, 2002. The patient developed exertional dyspnea with hypoxemia in the middle of June 2002 and was admitted to our hospital. The chest X-ray and chest CT scans showed diffuse reticulonodular infiltrates in the lower lung fields. Pulmonary function tests revealed depletion of diffusion capacity for carbon monoxide. Bronchoalveolar lavage fluid contained increased percentages of lymphocytes, neutrophils and eosinophils, and a CD4/8 ratio was low. The transbronchial lung biopsy specimens demonstrated alveolar septal thickening with infiltration of mononuclear cells and intraalveolar organization. As drug-induced pneumonitis was suspected, bepridil was discontinued, resulting in improvement of dyspnea and hypoxemia. The patient was then treated with corticosteroid, which led to complete resolution of infiltration on chest X-ray. According to the clinical data consistent with drug-induced pneumonia, the prompt improvement after cessation of bepridil and the absence of other possible causes, we diagnosed this case as bepridil-induce pnemonitis.
Okubo
Fumiko
F
Third Department of Internal Medicine, Oita University Faculty of Medicine.
Ando
Masaru
M
Ashihara
Yoshinori
Y
Okubo
Toshiyuki
T
Nishitake
Takahiro
T
Ito
Takeo
T
Matsuno
Osamu
O
Fukami
Tetsujiro
T
Miyazaki
Eishi
E
Kumamoto
Toshihide
T
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy; D015764:Bepridil / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000139:chemically induced*
D000889:Anti-Arrhythmia Agents; D015764:Bepridil