A case of drug-induced eosinophilic pneumonia caused by acetaminophen that was diagnosed by accidental readministration of the combination remedy for colds
Akane Sasakia,b Kengo Muratab Yu Sato Akihiko Wadab Mikio Takamorib
aDepartment of Respiratory Medicine, Chiba University Hospital
bDepartment of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center
An 80-year-old woman was admitted to our hospital because of dyspnea and fever. She had been taken Calonal®, which includes acetaminophen as the active ingredient. Increased eosinophils in bronchoalveolar lavage fluid suggested that she had an eosinophilic pneumonia (EP). Her pulmonary involvement resolved after discontinuation of acetaminophen and administration of corticosteroid. Six months later, she visited our hospital again because of dyspnea. She had been taking Coughcode®-N, a combination cold remedy that contains acetaminophen, before the arrival. The patient's history, increased eosinophils in the peripheral blood, and the radiologic findings were consistent with a relapse of drug-induced EP caused by acetaminophen. Pulmonary involvements improved immediately after discontinuation of acetaminophen and the administration of corticosteroid. This valuable case diagnosed by readministration of acetaminophen as a combination remedy underlines that acetaminophen can induce EP and that we must pay special attention when prescribing combination products.
Drug-induced pneumonitis Eosinophilic pneumonia Bronchoalveolar lavage Acetaminophen Drug-challenge test
Received 18 Mar 2014 / Accepted 14 Jul 2014
AJRS, 3(6): 813-817, 2014