Case Report

A case with life-threatening interstitial pneumonia associated with bucillamine treatment

Authors

Yuiko Ogiwara¹, Hideaki Mochizuki¹, Takehiko Morioka², Takahiko Sugihara³, Fumihiko Makino¹ and Hideki Takahashi¹

1. Division of Respiratory Medicine, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 177-0015, Japan
2. Division of Hematology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 177-0015, Japan
3. Division of Medicine and Rheumatology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo 177-0015, Japan

Received:

10 March 2008

Accepted:

17 April 2008

Published online:

28 May 2008

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Abstract

We report a case of bucillamine-induced interstitial pneumonia accompanied by severe hypoxemia in an 83-year-old woman who had rheumatoid arthritis. Respiratory failure worsened even after withdrawal of bucillamine and administration of high-dose corticosteroids, and mechanical ventilation was required. A review of 15 cases with bucillamine-induced pulmonary injury suggests that advanced age may be associated with the development of severe interstitial pneumonia. Bucillamine can cause corticosteroid-resistant and life-threatening lung injury, especially in the elderly.

Key words

Bucillamine - Elderly - Interstitial pneumonia - Lung injury - Rheumatoid arthritis