Kakuta Takuya, Hirata Hirokuni, Soda Sayo, Shiobara Taichi, Watanabe Mineaki, Tatewaki Masamitsu, Fukushima Fumiya, Chibana Kazuyuki, Sugiyama Kumiya, Arima Masafumi, Koichi Honma, Fukuda Takeshi, Fukushima Yasutsugu
Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University, Japan.
Intern Med. 2012;51(14):1903-7. doi: 10.2169/internalmedicine.51.6522. Epub 2012 Jul 15.
Riluzole has recently been proven as the first effective drug for the treatment of amyotrophic lateral sclerosis (ALS). We report two rare cases of lung injury caused by riluzole therapy in patients with ALS. Chest radiographs showed bilateral lower lobe, dorsal-dominant ground glass opacity, and/or consolidation. A drug lymphocyte stimulation test (DLST) of peripheral blood or bronchoalveolar lavage cells was positive for riluzole. Histopathological examination of lung biopsy specimens revealed lung injury without fungoid granuloma, vasculitis, or diffuse alveolar damage. To the best of our knowledge, this is the first report of riluzole-induced lung injury with positive DLST results.
利鲁唑最近已被证实是治疗肌萎缩侧索硬化症(ALS)的首个有效药物。我们报告了两例ALS患者因利鲁唑治疗导致肺损伤的罕见病例。胸部X线片显示双侧下叶、以背部为主的磨玻璃影和/或实变。外周血或支气管肺泡灌洗细胞的药物淋巴细胞刺激试验(DLST)对利鲁唑呈阳性。肺活检标本的组织病理学检查显示肺损伤,无真菌样肉芽肿、血管炎或弥漫性肺泡损伤。据我们所知,这是首例DLST结果呈阳性的利鲁唑所致肺损伤报告。