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A Case of Mexiletine-induced Hypersensitivity Syndrome Presenting as Eosinophilic Pneumonia

An 82-yr-old man was presented with fever and cough accompanied by generalized erythematous rash. He had taken mexiletine for 5 months, as he had been diagnosed with dilated cardiomyopathy and ventricular arrhythmia. Laboratory studies showed peripheral blood eosinophilia and elevated liver transami...

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Autores principales: Lee, Sang-Pyo, Kim, Sang-Heon, Kim, Tae Hyung, Sohn, Jang Won, Shin, Dong Ho, Park, Sung Soo, Yoon, Ho Joo
Formato: Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800002/
https://www.ncbi.nlm.nih.gov/pubmed/20052362
http://dx.doi.org/10.3346/jkms.2010.25.1.148
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author Lee, Sang-Pyo
Kim, Sang-Heon
Kim, Tae Hyung
Sohn, Jang Won
Shin, Dong Ho
Park, Sung Soo
Yoon, Ho Joo
author_facet Lee, Sang-Pyo
Kim, Sang-Heon
Kim, Tae Hyung
Sohn, Jang Won
Shin, Dong Ho
Park, Sung Soo
Yoon, Ho Joo
author_sort Lee, Sang-Pyo
collection PubMed
description An 82-yr-old man was presented with fever and cough accompanied by generalized erythematous rash. He had taken mexiletine for 5 months, as he had been diagnosed with dilated cardiomyopathy and ventricular arrhythmia. Laboratory studies showed peripheral blood eosinophilia and elevated liver transaminase levels. Chest radiographs showed multiple nodular consolidations in both lungs. Biopsies of the lung and skin lesions revealed eosinophilic infiltration. After a thorough review of his medication history, mexiletine was suspected as the etiologic agent. After discontinuing the mexiletine and starting oral prednisolone, the patient improved, and the skin and lung lesions disappeared. Subsequently, mexiletine was confirmed as the causative agent based on a positive patch test. Drug-induced hypersensitivity syndrome is a severe adverse reaction to drugs and results from treatment with anticonvulsants, allopurinol, sulfonamides, and many other drugs. Several cases of mexiletine-induced hypersensitivity syndrome have been reported in older Japanese males with manifestation of fever, rash, peripheral blood eosinophilia, liver dysfunction without other organ involvement. Here, we report a case of mexiletine-induced hypersensitivity syndrome which presented as eosinophilic pneumonia in a Korean male.
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spelling pubmed-28000022010-01-05 A Case of Mexiletine-induced Hypersensitivity Syndrome Presenting as Eosinophilic Pneumonia Lee, Sang-Pyo Kim, Sang-Heon Kim, Tae Hyung Sohn, Jang Won Shin, Dong Ho Park, Sung Soo Yoon, Ho Joo J Korean Med Sci Case Report An 82-yr-old man was presented with fever and cough accompanied by generalized erythematous rash. He had taken mexiletine for 5 months, as he had been diagnosed with dilated cardiomyopathy and ventricular arrhythmia. Laboratory studies showed peripheral blood eosinophilia and elevated liver transaminase levels. Chest radiographs showed multiple nodular consolidations in both lungs. Biopsies of the lung and skin lesions revealed eosinophilic infiltration. After a thorough review of his medication history, mexiletine was suspected as the etiologic agent. After discontinuing the mexiletine and starting oral prednisolone, the patient improved, and the skin and lung lesions disappeared. Subsequently, mexiletine was confirmed as the causative agent based on a positive patch test. Drug-induced hypersensitivity syndrome is a severe adverse reaction to drugs and results from treatment with anticonvulsants, allopurinol, sulfonamides, and many other drugs. Several cases of mexiletine-induced hypersensitivity syndrome have been reported in older Japanese males with manifestation of fever, rash, peripheral blood eosinophilia, liver dysfunction without other organ involvement. Here, we report a case of mexiletine-induced hypersensitivity syndrome which presented as eosinophilic pneumonia in a Korean male. The Korean Academy of Medical Sciences 2010-01 2009-12-29 /pmc/articles/PMC2800002/ /pubmed/20052362 http://dx.doi.org/10.3346/jkms.2010.25.1.148 Text en © 2010 The Korean Academy of Medical Sciences. http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Lee, Sang-Pyo
Kim, Sang-Heon
Kim, Tae Hyung
Sohn, Jang Won
Shin, Dong Ho
Park, Sung Soo
Yoon, Ho Joo
A Case of Mexiletine-induced Hypersensitivity Syndrome Presenting as Eosinophilic Pneumonia
title A Case of Mexiletine-induced Hypersensitivity Syndrome Presenting as Eosinophilic Pneumonia
title_full A Case of Mexiletine-induced Hypersensitivity Syndrome Presenting as Eosinophilic Pneumonia
title_fullStr A Case of Mexiletine-induced Hypersensitivity Syndrome Presenting as Eosinophilic Pneumonia
title_full_unstemmed A Case of Mexiletine-induced Hypersensitivity Syndrome Presenting as Eosinophilic Pneumonia
title_short A Case of Mexiletine-induced Hypersensitivity Syndrome Presenting as Eosinophilic Pneumonia
title_sort case of mexiletine-induced hypersensitivity syndrome presenting as eosinophilic pneumonia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800002/
https://www.ncbi.nlm.nih.gov/pubmed/20052362
http://dx.doi.org/10.3346/jkms.2010.25.1.148
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