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[Clomipramine hypersensitivity with predominantly pulmonary involvement].

J Gallego¹, P-A Hauss, M Salaün

¹EA4108, clinique pneumologique, université de Rouen, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.

Revue Des Maladies Respiratoires

|March 24, 2012

Summary

Drug hypersensitivity with organ damage (DRESS) syndrome is rare. This case highlights clomipramine-induced DRESS syndrome primarily affecting the lungs with eosinophilic infiltration.

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Area of Science:

Medicine
Pharmacology
Pulmonology

Background:

Drug hypersensitivity reactions (DHRs) encompass a spectrum of immune-mediated adverse drug reactions.
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe, idiosyncratic DHR.
Pulmonary involvement in DRESS syndrome is infrequent, typically presenting as eosinophilic lung disease.

Observation:

A case of DRESS syndrome is presented, triggered by the antidepressant clomipramine.
The patient exhibited significant and predominant pulmonary manifestations.
Eosinophilic infiltration was the primary characteristic of the lung involvement.

Findings:

Clomipramine can induce DRESS syndrome, a rare but serious adverse drug reaction.
Pulmonary involvement, though uncommon, can be a dominant feature of DRESS syndrome.
Eosinophilic infiltration is a key pathological finding in DRESS-related lung disease.

Implications:

Clinicians should consider DRESS syndrome in patients with unexplained pulmonary infiltrates and eosinophilia, especially after starting new medications.
Early recognition and withdrawal of the offending drug are crucial for managing DRESS syndrome.
This case underscores the importance of recognizing diverse clinical presentations of DRESS syndrome, including atypical pulmonary dominance.