Al-Ghamdi Badr Rashed
Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Case Rep Med. 2020 Apr 25;2020:9751837. doi: 10.1155/2020/9751837. eCollection 2020.
Sarcoidosis is a systemic disorder characterized by the presence of noncaseating granulomas that are most commonly observed in the lungs. Sarcoid-like reaction has been reported to develop in response to several immune modulator agents and antidepressants. In this report, a case of pulmonary sarcoidosis that was strongly related to the use of more than the average recommended dose of selective serotonin-reuptake inhibitor (SSRI) medications has been described. The patient, a 37-year-old, single, Caucasian woman, who suffered from severe depression and who presented to the emergency department with shortness of breath, low-grade fever, a dry cough, fatigue, and the loss of appetite, was diagnosed with this condition, and she failed to respond to the administered sarcoidosis treatment until the SSRI medications that she was using were discontinued; furthermore, she relapsed when one of these medications was reintroduced. Based on these observations, we were able to show a possible relationship between sarcoid-like reaction and SSRIs, and therefore, in the case of patients with interstitial lung diseases who are using SSRIs, we recommend that meticulous precautions be taken while planning their treatment and careful follow-ups be implemented to monitor their progress.
结节病是一种全身性疾病，其特征是存在非干酪样肉芽肿，最常见于肺部。据报道，类结节样反应可因多种免疫调节剂和抗抑郁药而发生。在本报告中，描述了一例与使用超过平均推荐剂量的选择性5-羟色胺再摄取抑制剂（SSRI）药物密切相关的肺结节病病例。该患者为一名37岁单身白人女性，患有严重抑郁症，因呼吸急促、低热、干咳、疲劳和食欲不振就诊于急诊科，被诊断为此病，在停用所使用的SSRI药物之前，她对所给予的结节病治疗无反应；此外，当重新引入其中一种药物时，她复发了。基于这些观察结果，我们能够证明类结节样反应与SSRI之间可能存在关联，因此，对于正在使用SSRI的间质性肺疾病患者，我们建议在制定治疗方案时要格外谨慎，并进行仔细的随访以监测其病情进展。
