Drug-induced lung injury due to bepridil with positive DLST after spontaneous improvement in clinical features
Shingo Tokita Hirokuni Hirata Kei Sugitate Mineaki Watanabe Hiroyuki Masuda Yasutsugu Fukushima
Department of Respiratory Medicine and Clinical Immunology, Dokkyo Medical University Koshigaya Hospital
Bepridil is an antiarrhythmic drug with few reports of drug-induced lung injury. We report the case of a 73-year-old woman who had commenced treatment with oral bepridil 4 months earlier and subsequently developed cough and difficulty in breathing more than 1 month prior to presentation. Initial evaluation at our department revealed infiltrative shadows in both lung fields on chest-computed tomography. Serum KL-6 levels were 10,570U/mL. A drug-induced lymphocyte stimulation test (DLST) was negative. Bronchoscopy and bronchoalveolar lavage fluid analysis revealed 41% lymphocyte cell subpopulations. Based on a high index of suspicion of drug-induced lung injury due to bepridil, oral administration was stopped immediately, resulting in spontaneous resolution of symptoms. A repeat DLST performed 1 year after drug discontinuation was positive. We report this as a rare case of spontaneous resolution of symptoms in which DLST became positive after discontinuation of the drug.
Bepridil Drug-induced lymphocyte stimulation test Spontaneous improvement Drug-induced lung injury
Received 24 May 2017 / Accepted 28 Aug 2017
AJRS, 6(6): 473-478, 2017