title: [A case of valsartan-induced pneumonitis with marked elevation of serum KL-6].
abstract: A 64-year-old man, who had been treated with valsartan for hypertension since about 2 months previously, was admitted with exertional dyspnea. A chest X-ray film on admission showed infiltrative shadows in bilateral lower lung fields. Chest computed tomographic images showed diffuse ground-glass opacities, consolidation and traction bronchiectasis. His serum KL-6 level was markedly elevated, to 7,360 U/ml. Despite the withdrawal of valsartan, his symptoms deteriorated, and a drug lymphocyte stimulation test was positive for valsartan. Based on these findings, we diagnosed valsartan-induced pneumonitis. Glucocorticoids were administered, and his symptoms, chest radiograph findings and serum KL-6 level all improved. Currently, angiotensin II receptor blockers (ARBs), including valsartan, are often used as the first drug of choice to treat hypertension, but they can cause drug-induced pneumonitis. It has been previously reported that serum KL-6 levels may reflect the clinical activity of drug-induced pneumonitis. In cases of drug-induced pneumonitis with a high level of serum KL-6, glucocorticolds should be started at an early stage.
authors.forename: Akira
authors.initials: A
authors.lastname: Takakura
authors.forename: Masaru
authors.initials: M
authors.lastname: Kubota
authors.forename: Sakiko
authors.initials: S
authors.lastname: Otani
authors.forename: Ken
authors.initials: K
authors.lastname: Katono
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Masuda
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood*; D011014:Pneumonia / Q000097:blood / Q000139:chemically induced*; D013777:Tetrazoles / Q000009:adverse effects*; D014633:Valine / Q000009:adverse effects / Q000031:analogs & derivatives*; D000068756:Valsartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; C060192:MUC1 protein, human; D018396:Mucin-1; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine