title: [A possible case of drug-induced pneumonia due to L-carbocisteine].
abstract: A 70-year-old man presented with a deteriorating fever and productive cough after the administration of drugs including L-carbocisteine against the common cold. Since chest radiograph revealed pulmonary infiltrates in the right lower lung field, he was admitted to our hospital, then L-carbocisteine was continued and antibiotics started. However, his symptoms, laboratory findings, and hypoxia worsened. Pulmonary infiltrates on his chest radiograph increased and chest CT demonstrated pulmonary consolidation with traction bronchiectasis and ground glass opacity with thickened of interlobular septae in the right lung field. Analysis of bronchoalveolar lavage fluid showed elevated numbers of total cells, neutrophils and eosinophils, and the CD4/CD8 ratio was 5.65. Under a suspected diagnosis of drug-induced pneumonia, we halted L-carbocisteine administration stopped and began corticosteroid therapy. Subsequently his symptoms and findings markedly improved. The drug lymphocyte stimulation test for L-carbocisteine using peripheral blood lymphocytes showed positive results. On the basis of the clinical course, laboratory and radiographic findings, we considered this case to possibly be drug-induced pneumonia due to L-carbocisteine. To our knowledge, this is possibly the first case of L-carbocisteine-induced pneumonia to be reported.
authors.affiliation: Division of Respiratory Medicine, Respirology and Stress Care Center, Kagoshima University Hospital.
authors.forename: Yoshimizu
authors.initials: Y
authors.lastname: Koreeda
authors.forename: Asako
authors.initials: A
authors.lastname: Tanoue
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kumamoto
authors.forename: Kouji
authors.initials: K
authors.lastname: Kubota
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hagihara
authors.forename: Tetsuhiko
authors.initials: T
authors.lastname: Taira
authors.forename: Satoshi
authors.initials: S
authors.lastname: Noma
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kawabata
authors.forename: Takayuki
authors.initials: T
authors.lastname: Suetsugu
authors.forename: Wataru
authors.initials: W
authors.lastname: Matsuyama
authors.forename: Keiko
authors.initials: K
authors.lastname: Mizuno
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kawabata
authors.forename: Ikkou
authors.initials: I
authors.lastname: Higashimoto
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Osame
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Arimura
mesh_terms: D000368:Aged; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D002233:Carbocysteine / Q000009:adverse effects*; D003139:Common Cold / Q000188:drug therapy; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000139:chemically induced*
chemical_list: D000891:Anti-Infective Agents, Local; D002233:Carbocysteine