title: [A case of salazosulfapyridine-induced pneumonitis presenting with multiple pulmonary nodules and lymphadenopathy].
abstract: We report a rare case of drug-induced pneumonitis, probably caused by salazosulfapyridine, showing a radiographic pattern of multiple pulmonary nodules and lymphadenopathy. An 18-year-old woman was admitted to our hospital because of fever, skin rash, dry cough and dyspnea on exertion. She had been given salazosulfapyridine for two weeks to treat Crohn's disease. A chest radiograph and computed tomographic scan showed multiple nodular shadows in both lung fields, mediastinal lymphadenopathy, and bilateral pleural effusions. Cessation of salazosulfapyridine followed by corticosteroid therapy led to an immediate symptomatic improvement. The drug-induced lymphocyte stimulation test for salazosulfapyridine was negative. The same symptoms reappeared with rechallenge of SASP, however, which led to diagnosis as salazosulfapyridine-induced pneumonitis. This is apparently the first case report of salazosulfapyridine-induced pneumonitis with a radiographic pattern of multiple pulmonary nodules; accumulation of similar case reports are needed to confirm the association.
authors.affiliation: Department of Internal Medicine, Social Insurance Central General Hospital.
authors.forename: Shogo
authors.initials: S
authors.lastname: Kasai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tokuda
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nishine
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D011014:Pneumonia / Q000139:chemically induced*; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D012460:Sulfasalazine / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D012460:Sulfasalazine