Kitaguchi S, Miyazawa T, Minesita M, Doi M, Takahashi K, Yamakido M
Department of Internal Medicine, Hiroshima City Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Jul;30(7):1322-6.
A 20-year-old woman took 1.2 g of acetaminophen for toothache. She subsequently developed a dry cough, pyrexia, and dyspnea. Chest X-ray revealed diffuse reticulo-nodular shadows in both lung fields. Broncho-alveolar lavage examination showed a marked increase in the total cell number and an increase in the percentage of eosinophils, neutrophils, and lymphocytes. Because drug-induced pneumonitis was suspected, all drugs were stopped and she was administered methylprednisolone. Consequently her symptoms resolved, and pulmonary function and chest X-ray findings improved remarkably. The lymphocyte stimulation test was positive for Norshin and its acetaminophen element. Based on these findings, the diagnosis of acetaminophen-induced pneumonitis was made. Acetaminophen intoxication is well-known, but to our knowledge this is the first reported case of acetaminophen-induced allergic pneumonitis in Japan.
一名20岁女性因牙痛服用了1.2克对乙酰氨基酚。随后她出现干咳、发热和呼吸困难。胸部X线显示双肺野弥漫性网状结节阴影。支气管肺泡灌洗检查显示细胞总数显著增加，嗜酸性粒细胞、中性粒细胞和淋巴细胞百分比升高。由于怀疑是药物性肺炎，停用了所有药物，并给予她甲泼尼龙治疗。结果她的症状得到缓解，肺功能和胸部X线表现明显改善。淋巴细胞刺激试验对Norshin及其对乙酰氨基酚成分呈阳性。基于这些发现，诊断为对乙酰氨基酚所致肺炎。对乙酰氨基酚中毒众所周知，但据我们所知，这是日本首例有报道的对乙酰氨基酚所致过敏性肺炎病例。
