[A case of Sjögren syndrome with nifedipine-induced pneumonia]

A 54-year-old woman started to take nifedipine orally for hypertension on February 18, 2006. From April 10, 2007, fever, tachycardia and chest pain appeared. Chest radiography showed a consolidation shadow in the right upper lobe. Administration of antibiotics was started because bacterial pneumonia was suspected. After the administration of antibiotics, the condition of the patient was aggravated and the consolidation shadow in the chest radiograph increased. Consequently, she was hospitalized for examination. Transbronchial lung biopsy was carried out on April 27, 2008. Pathological analysis revealed organization and inflammatory cell infiltration was observed in alveoli. Eosinophils were increased in the bronchial washing fluid. After halting administration of all drugs, the fever was alleviated. Since nifedipine was positive in DLST, drug-induced pneumonia caused by nifedipine was diagnosed. Salivary-gland biopsy was carried out on May 25, 2008 on the suspicion of Sjögren syndrome, because she continued to complain of dryness in the mouth and eyes. The pathological findings were consistent with Sjögren syndrome. To the best of our knowledge, there has been no report of drug-induced pneumonia caused by nifedipine. Since the case was complicated with Sjögren syndrome, some immunological dysregulation might have been a factor. In cases of lung impairment caused by a drug, it is necessary to consider the possibility of a immunologic disorder.