title: Acute eosinophilic pneumonia caused by calcium stearate, an additive agent for an oral antihistaminic medication.
abstract: A 70-year-old man was admitted to our hospital because of dyspnea after taking an antihistaminic agent (homochlorcyclizine hydrochloride) for itching. Chest roentgenogram showed infiltration in the left lung field, and laboratory data revealed eosinophilia. Examination of the bronchoalveolar lavage fluid revealed an increased eosinophil count. A drug lymphocyte stimulation test was positive only for calcium stearate, an additive contained in the homochlorcyclizine hydrochloride tablet. The pulmonary infiltration and clinical symptoms subsided after withdrawal of all drugs and initiation of glucocorticoid therapy. Therefore, we concluded that this patient's pulmonary disease was caused by calcium stearate, an additive for an antihistaminic drug. An allergic reaction to a drug's additive material should be considered as a rare cause of drug-induced acute eosinophilic pneumonia.
authors.affiliation: Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary InternalMedicine, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Kurai
authors.forename: Hiroki
authors.initials: H
authors.lastname: Chikumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kodani
authors.forename: Takanori
authors.initials: T
authors.lastname: Sako
authors.forename: Masanari
authors.initials: M
authors.lastname: Watanabe
authors.forename: Masanori
authors.initials: M
authors.lastname: Miyata
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Makino
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Touge
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hitsuda
authors.forename: Eiji
authors.initials: E
authors.lastname: Shimizu
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000368:Aged; D003501:Cyclizine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004802:Eosinophilia / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology; D006634:Histamine H1 Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011537:Pruritus / Q000188:drug therapy; D011657:Pulmonary Eosinophilia / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D013229:Stearic Acids / Q000008:administration & dosage / Q000009:adverse effects* / Q000032:analysis; D013607:Tablets / Q000737:chemistry
chemical_list: D006634:Histamine H1 Antagonists; D013229:Stearic Acids; D013607:Tablets; C031183:stearic acid; C034022:homochlorocyclizine; D003501:Cyclizine