title: [A case of drug-induced pneumonitis due to bepridil].
abstract: 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.
authors.affiliation: Third Department of Internal Medicine, Oita University Faculty of Medicine.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Okubo
authors.forename: Masaru
authors.initials: M
authors.lastname: Ando
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ashihara
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Okubo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nishitake
authors.forename: Takeo
authors.initials: T
authors.lastname: Ito
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsuno
authors.forename: Tetsujiro
authors.initials: T
authors.lastname: Fukami
authors.forename: Eishi
authors.initials: E
authors.lastname: Miyazaki
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kumamoto
mesh_terms: 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*
chemical_list: D000889:Anti-Arrhythmia Agents; D015764:Bepridil