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[Pulmonary eosinophilic infiltration with pneumothorax during trimipramine treatment]
1Medizinische Klinik, Kantonsspital Chur.
Abstract:
Three weeks after starting treatment with the antidepressant trimipramine a 55-year-old man developed increasing cough, fatigue and lack of appetite. The blood count revealed marked eosinophilia (15%) and the chest X-ray showed bilateral pulmonary infiltrates. Later a left spontaneous pneumothorax occurred. When trimipramine was discontinued (as the suspected cause of the described changes) the symptoms quickly subsided and the infiltrate as well as the eosinophilia quickly disappeared.
Insights
Trimipramine, an antidepressant, can cause serious lung issues like eosinophilia and pulmonary infiltrates. Discontinuing the drug quickly resolved these adverse effects.
Area of Science:
- Pulmonology
- Pharmacology
- Internal Medicine
Background:
- Trimipramine is a tricyclic antidepressant used for treating depression.
- Adverse drug reactions can manifest in various organ systems, including the lungs.
Observation:
- A 55-year-old male patient developed cough, fatigue, and anorexia three weeks after initiating trimipramine.
- Clinical examination revealed significant eosinophilia (15%) and bilateral pulmonary infiltrates on chest X-ray.
- The patient later experienced a spontaneous pneumothorax.
Findings:
- Discontinuation of trimipramine led to rapid resolution of symptoms.
- Pulmonary infiltrates and eosinophilia also resolved quickly after drug cessation.
Implications:
- Trimipramine should be considered a potential cause of drug-induced lung disease.
- Early recognition and discontinuation of the offending agent are crucial for managing trimipramine-induced pulmonary complications.
- This case highlights the importance of considering iatrogenic causes for respiratory symptoms in patients on antidepressant therapy.