Nakatsumi Y, Nomura M, Yasui M, Fujimura M, Matsuda T, Kitagawa M
Third Department of Internal Medicine, Kanazawa University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Oct;31(10):1322-6.
We report a case of pneumonitis induced by tolfenamic acid. A 23-year-old woman was admitted to our hospital because of cough and fever. She had been treated with tolfenamic acid and other medications for lumbago. Nine days after the treatment, she developed erythema, fever, cough and dyspnea. Her chest X-ray revealed multiple patchy and micronodular shadows in both lung fields. Bronchoalveolar lavage fluid (BALF) showed increased total cells, lymphocytes, eosinophils and CD4/CD8 ratio. Microscopic examination of transbronchial lung biopsy (TBLB) specimens showed infiltration of mononuclear cells and eosinophils into the alveolar wall and the interstitium. After discontinuation of all drugs, her complaints, laboratory data and chest X-ray findings markedly improved. The lymphocyte stimulation test (LST) and challenge test for tolfenamic acid were positive. Based on these findings, we diagnosed this case as pneumonitis (eosinophilic pneumonia) due to tolfenamic acid. To our knowledge, there has been no reported case of pneumonitis due to this drug in Japan.
我们报告一例由托芬那酸引起的肺炎病例。一名23岁女性因咳嗽和发热入院。她曾因腰痛接受托芬那酸及其他药物治疗。治疗九天后，她出现红斑、发热、咳嗽和呼吸困难。胸部X线显示双肺野有多个斑片状和微小结节阴影。支气管肺泡灌洗液（BALF）显示总细胞、淋巴细胞、嗜酸性粒细胞增多及CD4/CD8比值升高。经支气管肺活检（TBLB）标本的显微镜检查显示单核细胞和嗜酸性粒细胞浸润至肺泡壁和间质。停用所有药物后，她的症状、实验室数据及胸部X线表现明显改善。托芬那酸的淋巴细胞刺激试验（LST）和激发试验呈阳性。基于这些发现，我们将该病例诊断为托芬那酸所致的肺炎（嗜酸性粒细胞性肺炎）。据我们所知，日本尚无该药物引起肺炎的报道病例。
