Minocycline-induced acute eosinophilic pneumonia: controversial results of lymphocyte stimulation test and re-challenge test.
We report an instructive case of minocycline-induced eosinophilic pneumonia confirmed by re-challenge test, in which a preceding lymphocyte-stimulation test indicated acetaminophen as the etiologic agent. A 55-year-old woman developed high fever and lung infiltrates with pulmonary eosinophilia after exposure to minocycline, acetaminophen, theophylline and procaterol. All of the medicines were discontinued, resulting in prompt improvement. The lymphocyte stimulation tests provided a positive result for acetaminophen, but not for the other medicines; however, a negative result was given by a re-challenge test with acetaminophen. In contrast, symptoms and hypoxemia reappeared when minocycline was re-administered. We would like to emphasize that lymphocyte stimulation test results need to be carefully interpreted for individual drugs.
Ono
Emiko
E
Division of Pulmonary Disease, Oita University Faculty of Medicine, Oita, Japan.
Miyazaki
Eishi
E
Matsuno
Osamu
O
Nureki
Shin-ichi
S
Okubo
Toshiyuki
T
Ando
Masaru
M
Kumamoto
Toshihide
T
D000082:Acetaminophen / Q000009:adverse effects; D000208:Acute Disease; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced; D007158:Immunologic Techniques / Q000592:standards*; D008213:Lymphocyte Activation; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects*; D011657:Pulmonary Eosinophilia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
D018712:Analgesics, Non-Narcotic; D000900:Anti-Bacterial Agents; D000082:Acetaminophen; D008911:Minocycline