Oda H, Doutsu Y, Hiratani K, Miyazaki T, Komori K, Hayashi T, Kohno S, Yamaguchi K, Hirota M, Hara K
Second Department of Internal Medicine, Nagasaki University School of Medicine.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jan;28(1):183-8.
A 73-year-old man had been treated with Aprindine because of paroxysmal atrial fibrillation. On July 13, 1987, five months after the commencement of aprindine administration, he developed dyspnea and low grade fever. His chest X-ray revealed multiple infiltrative shadows in both lung fields. He was treated by various antibiotics, but the infiltrative shadows increased. BALF showed increased percentage of lymphocytes and a decrease in the OKT4/T8 ratio, and the histological findings of TBLB carried out on August 6, 1987, showed alveolitis with Masson bodies. The lymphocyte stimulation test by drugs was positive only for aprindine. After cessation of Aprindine administration, his complaints and laboratory data improved, but his abnormal shadow on chest X-ray did not diminish completely. Open lung biopsy was performed for differential diagnosis of BOOP, on Sep. 14, 1987. The histopathology of specimens of the lung was compatible with drug-induced pneumonitis. The administration of 30 mg of prednisolone was started on Oct. 14, 1987, and the dosage was decreased gradually. The abnormal shadow on chest X-ray improved. To our knowledge, there has been no reported case of Aprindine-induced pneumonitis, and this could be the first report.
一名73岁男性因阵发性心房颤动接受安搏律定治疗。1987年7月13日，即开始服用安搏律定五个月后，他出现呼吸困难和低热。胸部X线检查显示双肺野有多处浸润性阴影。他接受了多种抗生素治疗，但浸润性阴影增多。支气管肺泡灌洗显示淋巴细胞百分比增加，OKT4/T8比值降低，1987年8月6日经支气管肺活检的组织学检查结果显示为伴有马松小体的肺泡炎。药物淋巴细胞刺激试验仅对安搏律定呈阳性。停用安搏律定后，他的症状和实验室数据有所改善，但胸部X线片上的异常阴影并未完全消失。1987年9月14日进行了开胸肺活检以鉴别闭塞性细支气管炎伴机化性肺炎（BOOP）。肺标本的组织病理学与药物性肺炎相符。1987年10月14日开始给予30毫克泼尼松龙，剂量逐渐减少。胸部X线片上的异常阴影有所改善。据我们所知，尚无安搏律定诱发肺炎的报道，这可能是首例报告。
