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Pirfenidone-induced Eosinophilic Pleurisy
Isano Hase1,2, Bunpei Yamaguchi1,2, Hidenori Takizawa1,2
1Department of Respiratory Disease, Southern Tohoku General Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|July 19, 2017
Summary
Pirfenidone, a treatment for idiopathic pulmonary fibrosis, can cause eosinophilic pleurisy. Discontinuing the drug resolved the patient's pleural effusion, suggesting a causal link.
Area of Science:
- Pulmonology
- Medical Case Reports
- Pharmacovigilance
Background:
- Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease.
- Pirfenidone is a medication used to treat IPF.
- Drug-induced pleural effusions are a known, albeit uncommon, adverse effect of various medications.
Observation:
- A 69-year-old male IPF patient on pirfenidone developed left-sided eosinophilic pleurisy.
- Medical thoracoscopy revealed significant eosinophil and lymphoid follicle infiltration in the parietal pleura.
- Pleural effusion resolved spontaneously after pirfenidone discontinuation.
Findings:
- This case suggests pirfenidone as a potential cause of drug-induced eosinophilic pleurisy.
- Histopathology confirmed eosinophilic infiltration, characteristic of certain drug reactions.
- Cessation of pirfenidone led to complete resolution of symptoms and effusion.
Implications:
- Highlights the importance of considering pirfenidone in the differential diagnosis of eosinophilic pleurisy in IPF patients.
- Underscores the need for vigilant monitoring of potential adverse effects associated with pirfenidone therapy.
- Contributes to the pharmacovigilance data on pirfenidone, particularly regarding rare pulmonary complications.
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