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Fluoxetin-induced pulmonary granulomatosis
E de Kerviler1, J Trédaniel, G Revlon
1Service de Radiologie, Hôpital Saint-Louis, Paris, France.
The European Respiratory Journal
|March 1, 1996
Summary
Fluoxetine, used for manic depressive disorder, can cause lung inflammation, including granulomas and pneumonia. Symptoms resolved after discontinuing the medication, indicating a drug-induced lung injury.
Area of Science:
- Pulmonology
- Pharmacology
- Pathology
Background:
- Drug-induced lung diseases are a significant concern in clinical practice.
- Selective serotonin reuptake inhibitors (SSRIs) have been rarely associated with pulmonary toxicity.
Observation:
- A patient on fluoxetine for bipolar disorder developed asymptomatic pulmonary inflammatory nodules.
- Histopathological examination revealed noncaseating giant cell granulomas, interstitial pneumonia, and non-necrotizing vasculitis.
- The patient remained asymptomatic despite significant pulmonary changes.
Findings:
- Pulmonary nodules showed progressive resolution after fluoxetine withdrawal.
- Chest radiography normalized within 9 months post-discontinuation.
- Open lung biopsy confirmed the diagnosis of drug-induced pulmonary disease.
Implications:
- Fluoxetine can be associated with rare, severe pulmonary toxicity.
- Early recognition and drug withdrawal are crucial for favorable outcomes.
- This case highlights the importance of considering medication side effects in unexplained pulmonary findings.