title: Vildagliptin-induced acute lung injury: a case report.
abstract: BACKGROUND
  Dipeptidyl peptidase-4 inhibitors are a class of oral hypoglycemic drugs and are used widely to treat type 2 diabetes mellitus in many countries. Adverse effects include nasopharyngitis, headache, elevated serum pancreatic enzymes, and gastrointestinal symptoms. In addition, a few cases of interstitial pneumonia associated with their use have been reported in the Japanese literature. Here we describe a patient who developed drug-induced acute lung injury shortly after the administration of the dipeptidyl peptidase-4 inhibitor vildagliptin.
  
  
  METHODS
  A 38-year-old Japanese woman with diabetes mellitus developed acute respiratory failure 1 day after administration of vildagliptin. Chest computed tomography revealed nonsegmental ground-glass opacities in her lungs. There was no evidence of bacterial pneumonia or any other cause of her respiratory manifestations. After discontinuation of vildagliptin, she recovered fully from her respiratory disorder. She received insulin therapy for her diabetes mellitus, and her subsequent clinical course has been uneventful.
  
  
  CONCLUSIONS
  The period of drug exposure in previously reported cases of patients with drug-induced interstitial pneumonia caused by dipeptidyl peptidase-4 inhibitor varied from several days to over 6 months. In the present case, our patient developed interstitial pneumonia only 1 day after the administration of vildagliptin. The precise mechanism of her vildagliptin-induced lung injury remains uncertain, but physicians should consider that dipeptidyl peptidase-4 inhibitor-induced lung injury, although rare, may appear acutely, even within days after administration of this drug.
authors: Department of Endocrinology and Metabolism, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka, Niigata, 940-2085, Japan. oharan@med.niigata-u.ac.jp.|Department of Endocrinology and Metabolism, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan. oharan@med.niigata-u.ac.jp.
authors: Nobumasa
authors: N
authors: Ohara
authors: Department of Endocrinology and Metabolism, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka, Niigata, 940-2085, Japan.
authors: Masanori
authors: M
authors: Kaneko
authors: Department of Respiratory Medicine, Nagaoka Red Cross Hospital, Niigata, Japan.
authors: Kazuhiro
authors: K
authors: Sato
authors: Department of Pharmaceuticals, Nagaoka Red Cross Hospital, Niigata, Japan.
authors: Ryoko
authors: R
authors: Maruyama
authors: Department of Pharmaceuticals, Niitsu Medical Center Hospital, Niigata, Japan.
authors: Tomoyasu
authors: T
authors: Furukawa
authors: Department of Respiratory Medicine and Infectious Disease, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors: Junta
authors: J
authors: Tanaka
authors: Department of Endocrinology and Metabolism, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka, Niigata, 940-2085, Japan.
authors: Kenzo
authors: K
authors: Kaneko
authors: Center of Diabetes, Endocrinology and Metabolism, Joetsu General Hospital, Niigata, Japan.
authors: Kyuzi
authors: K
authors: Kamoi
mesh_terms: D055371:Acute Lung Injury / Q000139:chemically induced*; D000218:Adamantane / Q000009:adverse effects / Q000031:analogs & derivatives*; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D009570:Nitriles / Q000009:adverse effects*; D011759:Pyrrolidines / Q000009:adverse effects*; D000077597:Vildagliptin
chemical_list: D007004:Hypoglycemic Agents; D009570:Nitriles; D011759:Pyrrolidines; D000077597:Vildagliptin; D000218:Adamantane
keywords: Acute respiratory failure; Diabetes mellitus; Dipeptidyl peptidase-4 inhibitor; Elevated pancreatic enzyme; Ground-glass opacity; Human leukocyte antigen; Leukocyte migration test