National and Kapodistrian University of Athens, Medical School, 2nd Department of Psychiatry, University ATTIKON General Hospital, 12462 Athens, Greece.
Gen Hosp Psychiatry. 2011 Jul-Aug;33(4):411.e7-9. doi: 10.1016/j.genhosppsych.2011.03.010. Epub 2011 May 5.
Acute Eosinophilic Pneumonia (AEP) is a severe syndrome which can be potentially induced by many reasons, including drugs. It is characterized by pulmonary infiltrates, peripheral blood eosinophilia and respiratory failure. AEP has rarely been associated with antidepressant treatment.
We report a case of an 80-year-old woman who presented with fever, lung infiltrates, peripheral blood eosinophilia and acute respiratory failure. All evidence charge venlafaxine as the only possible causal factor. The syndrome rapidly resolved after discontinuation of the drug and upon reception of corticosteroids in low doses. The patient had a past medical history of AEP induced by sertraline and a recent medical history of Acute Lung Injury on the context of acute pancreatitis during treatment with venlafaxine.
Pathophysiological mechanisms implicated in the development of AEP in our patient seems to be associated with eotaxin and serotonin eosinophilic-specific chemoattracting action.
This is a case report with clinical adverse reaction of AEP in two antidepressant agents (venlafaxine and sertraline) with a similar neurochemical mechanism of action via the serotoninergic system.
急性嗜酸性肺炎（AEP）是一种严重的综合征，可能由多种原因引起，包括药物。其特征是肺部浸润、外周血嗜酸性粒细胞增多和呼吸衰竭。AEP 很少与抗抑郁治疗有关。
我们报告了一例 80 岁女性患者，表现为发热、肺部浸润、外周血嗜酸性粒细胞增多和急性呼吸衰竭。所有证据均表明文拉法辛是唯一可能的致病因素。停药后和低剂量接受皮质类固醇治疗后，综合征迅速缓解。该患者有 AEP 病史，由舍曲林引起，近期有急性胰腺炎背景下的急性肺损伤病史，当时正在使用文拉法辛治疗。
在我们的患者中，导致 AEP 的病理生理机制似乎与嗜酸性粒细胞趋化因子和 5-羟色胺嗜酸性粒细胞特异性趋化作用有关。
这是一例与两种抗抑郁药（文拉法辛和舍曲林）相关的 AEP 临床不良反应的病例报告，其通过 5-羟色胺能系统具有相似的神经化学作用机制。
