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Pulmonary eosinophilia associated with montelukast
Thorax
|May 21, 1999
Summary
Montelukast, a leukotriene modifier, may trigger eosinophilic lung conditions like Churg-Strauss syndrome in asthma patients. Early recognition and corticosteroid treatment are crucial for symptom reversal.
Area of Science:
- Pulmonology
- Allergology
- Pharmacology
Background:
- Antileukotriene drugs are novel asthma therapeutics.
- Cysteinyl leukotriene receptor 1 (CysLT1) antagonists are used for asthma management.
- Zafirlukast has been linked to eosinophilic conditions like Churg-Strauss syndrome.
Observation:
- A case of pulmonary eosinophilia developed in an asthma patient on montelukast.
- The patient had a history of allergic rhinitis and intermittent oral corticosteroid use.
- Montelukast is a CysLT1 receptor antagonist, distinct from zafirlukast.
Findings:
- Pulmonary infiltrates and symptoms resolved rapidly after discontinuing montelukast.
- Systemic corticosteroid administration facilitated symptom reversal and resolution of lung infiltrates.
- This suggests a potential association between montelukast and eosinophilic lung disease.
Implications:
- CysLT1 receptor antagonists are generally safe and effective for asthma.
- Caution is advised for severe asthma patients on systemic corticosteroids.
- Patients exhibiting prodromal Churg-Strauss syndrome characteristics require careful monitoring during CysLT1 antagonist therapy.