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Methylphenidate causes chronic eosinophilic pneumonia.

Dhafer Alghamdi¹, Hamdan Jahdali¹, Abdullah Alharbi¹

¹Department of Pulmonology, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Annals of Thoracic Medicine

|March 6, 2024

Summary

Methylphenidate, a medication for attention-deficit hyperactivity disorder, may cause eosinophilic pneumonia. This rare condition involves lung inflammation and improved after discontinuing the drug.

Keywords:

Allergy chronic eosinophilic pneumonia drug-induced lung injury methylphenidate

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Area of Science:

Pulmonology
Pharmacology
Toxicology

Background:

Attention-deficit hyperactivity disorder (ADHD) is commonly treated with stimulant medications.
Methylphenidate is a widely prescribed central nervous system stimulant for ADHD.
Drug-induced lung injury is a recognized but uncommon adverse effect of various medications.

Observation:

A 38-year-old male with ADHD developed progressive shortness of breath and cough three weeks after starting methylphenidate.
Chest imaging revealed bilateral ground-glass opacities.
Bronchoscopy showed significant eosinophilia in bronchoalveolar lavage fluid.

Findings:

Transbronchial biopsy confirmed eosinophilic pneumonia.
Symptoms resolved with corticosteroid treatment and methylphenidate discontinuation.
Recurrence of symptoms and a skin rash occurred upon methylphenidate re-challenge, strongly implicating the drug.

Implications:

This case highlights a potential association between methylphenidate and eosinophilic pneumonia.
Clinicians should consider methylphenidate as a possible cause of drug-induced lung disease in patients presenting with compatible symptoms.
Further investigation into the mechanisms of methylphenidate-induced hypersensitivity pneumonitis is warranted.