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Updated: Aug 13, 2026
Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
[Strong suspicion of lung toxicity due to riluzole]
L Borderías-Clau1, J Garrapiz-López, P Val-Adán
1Sección de Neumología, Hospital General San Jorge, Huesca, Spain. lborderias@separ.es
Abstract:
Riluzole is a drug used in the treatment of amyotrophic lateral sclerosis. To date, reports of lung toxicity have been exceptional. We present the case of a 74-year-old man diagnosed with amyotrophic lateral sclerosis. Following 3, 5 months of treatment with riluzole (Rilutek), the patient began to present a clinical picture consisting of nonproductive cough, progressive dyspnea (even with slight exertion), weakness, and radiologic progression with the appearance of predominantly peripheral bilateral pulmonary infiltrates that did not respond to treatment with amoxicillin-clavulanic acid. Bacterial tests did not reveal the presence of germs, nor did other examinations suggest an alternative diagnosis. The patient did not resume treatment with the drug or undergo complementary procedures aimed at obtaining histologic samples. Nevertheless, the coincidence in time, lack of response to antibiotic treatment, remission of symptoms following withdrawal of the drug without initiating any other treatment except 40 mg/d of methylprednisolone for 6 days, absence of alternative diagnoses, and suggestive clinical and radiologic findings all together point to toxicity due to riluzole.
Insights
Riluzole, used for amyotrophic lateral sclerosis, may cause rare lung toxicity. A patient experienced respiratory symptoms and lung infiltrates that resolved after discontinuing the drug.
Area of Science:
- Pulmonology
- Neurology
Background:
- Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease.
- Riluzole is a primary medication for ALS treatment.
- Lung toxicity associated with riluzole is considered rare.
Observation:
- A 74-year-old male ALS patient developed a nonproductive cough and progressive dyspnea.
- Radiological imaging revealed bilateral pulmonary infiltrates.
- Symptoms persisted despite antibiotic treatment and lack of alternative diagnoses.
Findings:
- The patient's condition improved significantly after discontinuing riluzole.
- Methylprednisolone treatment was administered for a short duration.
- The clinical presentation and response to drug withdrawal strongly suggest riluzole-induced lung toxicity.
Implications:
- This case highlights a potential, albeit rare, adverse effect of riluzole.
- Clinicians should consider riluzole-induced lung toxicity in ALS patients presenting with unexplained pulmonary symptoms.
- Further investigation into the mechanisms of riluzole pulmonary toxicity may be warranted.