title: A case of bucillamine-induced interstitial pneumonia with positive lymphocyte stimulation test for bucillamine using bronchoalveolar lavage lymphocytes.
abstract: A 64-year-old woman with rheumatoid arthritis and treated with bucillamine presented with a productive cough. No obvious infiltration was detected in chest radiography, but CT revealed patchy ground glass opacities in bilateral lung fields. Her serum KL-6 level was elevated and transbronchial lung biopsy showed interstitial pneumonia. Drug lymphocyte stimulation test (DLST) for bucillamine was negative for blood lymphocytes, but positive for bronchoalveolar lavage (BAL) lymphocytes. The pneumonitis improved after the cessation of bucillamine. We therefore made a diagnosis of bucillamine-induced interstitial pneumonia. DLST with BAL lymphocytes is thus suggested to be useful for such diagnoses.
authors.affiliation: Department of Internal Medicine, Division of Pulmonary Medicine, Nippon Medical School, Tokyo. yo-saito@nms.ac.jp
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Saito
authors.forename: Takahito
authors.initials: T
authors.lastname: Nei
authors.forename: Shinji
authors.initials: S
authors.lastname: Abe
authors.forename: Jiro
authors.initials: J
authors.lastname: Usuki
authors.forename: Arata
authors.initials: A
authors.lastname: Azuma
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nakayama
authors.forename: Yuh
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Shoji
authors.initials: S
authors.lastname: Kudoh
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D003545:Cysteine / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008168:Lung; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000175:diagnosis / Q000000981:diagnostic imaging; D008213:Lymphocyte Activation; D008875:Middle Aged; D011859:Radiography
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D003545:Cysteine; C026535:bucillamine