Melloni B, Vergnenègre A, Bonnaud F, Antonini M T, Gaillard S, Touraine F, Germouty J
Service de Pathologie Respiratoire et d'Allergologie, CHU Limoges.
Rev Mal Respir. 1994;11(3):308-11.
Cough is known to be the major respiratory side effect of treatment with angiotensin converting enzyme inhibitors (ACEI). Recently, ACEI have been implicated in drug-induced lung disease. We report a new case of diffuse pneumonitis which occurred during treatment with ACEI. A 73-year-old man was admitted for cough, dyspnea at rest, fever and weight loss. The patient had been treated with the ACEI pirindopril during 6 months for systemic hypertension. Chest radiographs showed reticular infiltrates in the upper lung fields. A CT scan confirmed the infiltrates and showed pleural thickening and airspace opacities. White blood cell counts showed 15,700/mm3 leucocytes with 940 eosinophils/mm3. Transbronchial biopsy was consistent with infiltration of the lung with eosinophils. There was no evidence for another etiology. Once the drug was withdrawn, clinical and radiological abnormalities improved but steroids were required to control symptoms. This report suggests that pirindopril, as captopril, can induce the picture of drug-induced pulmonary disease.
咳嗽是已知的血管紧张素转换酶抑制剂（ACEI）治疗的主要呼吸道副作用。最近，ACEI与药物性肺病有关。我们报告了1例在ACEI治疗期间发生的弥漫性肺炎新病例。一名73岁男性因咳嗽、静息时呼吸困难、发热和体重减轻入院。该患者因全身性高血压接受培哚普利（一种ACEI）治疗6个月。胸部X线片显示上肺野网状浸润。CT扫描证实了浸润，并显示胸膜增厚和肺实变。白细胞计数显示白细胞为15700/mm³，嗜酸性粒细胞为940/mm³。经支气管活检结果与肺嗜酸性粒细胞浸润一致。没有其他病因的证据。一旦停用该药物，临床和影像学异常有所改善，但需要使用类固醇来控制症状。本报告提示，培哚普利与卡托普利一样，可诱发药物性肺病。
