[A case of drug-induced pneumonia caused by propiverine: follow-up drug lymphocyte stimulation test useful for identification of the suspected drug].
A 75-year-old woman presented with general malaise and exertional dyspnea one week after the administration of propiverine, a urination-improving drug, with a diagnosis of neurogenic bladder. Her chest X-ray film and high-resolution computed tomography (HRCT) revealed bilateral, non-segmental, ground-glass opacities with partial consolidation and cord-shaped shadows. Bronchoalveolar lavage (BAL) fluid suggested an increase in the ratio of lymphocytes. A drug lymphocyte stimulation test (DLST) for propiverine showed a negative reaction 2 weeks after onset; however, a positive reaction was noted after a further 2 weeks. After the discontinuation of propiverine, the symptoms and imaging findings markedly improved. The clinical course suggested drug-induced pneumonia caused by propiverine. Considering the risk of additional administration and the necessity of subsequent prescription, drug provocation test was not performed. No study has reported propiverine-related lung injuries; however, as this agent is frequently prescribed in elderly patients, the possibility of drug-induced pneumonia must be considered.
Division of Pulmonary Medicine, Department of medicine, Hitachiomiya Saiseikai Hospital.
Masayuki
M
Nakayama
Masashi
M
Bando
Tatsuya
T
Hosono
Hideaki
H
Yamasawa
Shoji
S
Ohno
Yukihiko
Y
Sugiyama
D000368:Aged; D001561:Benzilates / Q000009:adverse effects*; D018680:Cholinergic Antagonists / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008213:Lymphocyte Activation; D011014:Pneumonia / Q000139:chemically induced*
D001561:Benzilates; D018680:Cholinergic Antagonists; C015586:propiverine