PMID- 34743720
OWN - NLM
STAT- MEDLINE
DCOM- 20220204
LR  - 20220204
IS  - 1471-2466 (Electronic)
IS  - 1471-2466 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Nov 7
TI  - Drug-induced hypersensitivity syndrome caused by minodronic acid hydrate.
PG  - 350
LID - 10.1186/s12890-021-01709-x [doi]
LID - 350
AB  - BACKGROUND: Drug-induced hypersensitivity syndrome (DIHS)/drug reaction with 
      eosinophilia and systemic symptoms (DRESS) syndrome is an important adverse 
      reaction caused by a few drugs. Reactivation of human herpesvirus 6 (HHV-6) is 
      known to be associated with its pathogenesis. DIHS occasionally manifests as 
      pulmonary lesions with a variety of imaging findings. CASE PRESENTATION: An 
      83-year-old woman started taking minodronic acid hydrate 5 years before 
      admission. She noticed a generalized skin rash 44 days before admission and 
      started oral betamethasone-d-chlorpheniramine maleate combination tablets for 
      allergic dermatitis. She developed a fever and cough in addition to the rash, and 
      was referred to our hospital. Laboratory data showed a high level of eosinophils 
      and liver and biliary enzymes. Computed tomography (CT) studies revealed 
      bilateral diffuse ground-glass opacities with ill-defined centrilobular nodules 
      from the central to peripheral regions of the lungs. Transbronchial lung 
      cryobiopsy specimens showed that lymphocyte infiltration was observed in the 
      alveolar walls and fibrinous exudates and floating macrophages in the alveolar 
      lumina. Immunohistochemistry of biopsy specimens showed more CD4(+) lymphocytes 
      than CD8(+) lymphocytes, while few Foxp3(+) lymphocytes were recognized. The 
      serum anti-HHV-6 immunoglobulin G titer increased at 3 weeks after the first 
      test. Based on these findings, we diagnosed her with DIHS. We continued care 
      without using corticosteroids since there was no worsening of breathing or skin 
      condition. Eventually, her clinical symptoms chest CT had improved. Minodronic 
      acid hydrate was identified as the culprit drug based on the positive results of 
      the patch test and drug-induced lymphocyte stimulation test. CONCLUSIONS: We 
      described the first case of DIHS caused by minodronic acid hydrate. Lung lesions 
      in DIHS can present with bilateral diffuse ground-glass opacities and ill-defined 
      centrilobular nodules on a CT scan during the recovery phase. Clinicians should 
      be aware of DIHS, even if patients are not involved with typical 
      DIHS/DRESS-causing drugs.
CI  - (c) 2021. The Author(s).
FAU - Muto, Yutaka
AU  - Muto Y
AUID- ORCID: 0000-0002-2580-0923
AD  - Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 
      Hiroo, Shibuya-ku, Tokyo, 150-8953, Japan. y.muto76@gmail.com.
FAU - Kuse, Naoyuki
AU  - Kuse N
AD  - Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 
      Hiroo, Shibuya-ku, Tokyo, 150-8953, Japan.
FAU - Inomata, Minoru
AU  - Inomata M
AD  - Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 
      Hiroo, Shibuya-ku, Tokyo, 150-8953, Japan.
FAU - Awano, Nobuyasu
AU  - Awano N
AD  - Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 
      Hiroo, Shibuya-ku, Tokyo, 150-8953, Japan.
FAU - Tone, Mari
AU  - Tone M
AD  - Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 
      Hiroo, Shibuya-ku, Tokyo, 150-8953, Japan.
FAU - Takada, Kohei
AU  - Takada K
AD  - Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 
      Hiroo, Shibuya-ku, Tokyo, 150-8953, Japan.
FAU - Fujimoto, Kazushi
AU  - Fujimoto K
AD  - Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 
      Hiroo, Shibuya-ku, Tokyo, 150-8953, Japan.
FAU - Bae, Yuan
AU  - Bae Y
AD  - Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, 
      Shibuya-ku, Tokyo, 150-8953, Japan.
FAU - Kumasaka, Toshio
AU  - Kumasaka T
AD  - Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, 
      Shibuya-ku, Tokyo, 150-8953, Japan.
FAU - Izumo, Takehiro
AU  - Izumo T
AD  - Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 
      Hiroo, Shibuya-ku, Tokyo, 150-8953, Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20211107
PL  - England
TA  - BMC Pulm Med
JT  - BMC pulmonary medicine
JID - 100968563
RN  - 0 (Diphosphonates)
RN  - 0 (Imidazoles)
RN  - 127657-42-5 (YM 529)
SB  - IM
MH  - Aged, 80 and over
MH  - Diphosphonates/*adverse effects
MH  - Drug Hypersensitivity Syndrome/*etiology/pathology
MH  - Female
MH  - Humans
MH  - Imidazoles/*adverse effects
MH  - Lung/diagnostic imaging/pathology
MH  - Skin Tests
PMC - PMC8572576
OTO - NOTNLM
OT  - Case report
OT  - Cryobiopsy
OT  - Drug reaction with eosinophilia and systemic symptoms
OT  - Drug-induced hypersensitivity syndrome
OT  - Interstitial lung disease
COIS- The authors declare that they have no competing interests.
EDAT- 2021/11/09 06:00
MHDA- 2022/02/05 06:00
PMCR- 2021/11/07
CRDT- 2021/11/08 05:35
PHST- 2021/01/16 00:00 [received]
PHST- 2021/10/25 00:00 [accepted]
PHST- 2021/11/08 05:35 [entrez]
PHST- 2021/11/09 06:00 [pubmed]
PHST- 2022/02/05 06:00 [medline]
PHST- 2021/11/07 00:00 [pmc-release]
AID - 10.1186/s12890-021-01709-x [pii]
AID - 1709 [pii]
AID - 10.1186/s12890-021-01709-x [doi]
PST - epublish
SO  - BMC Pulm Med. 2021 Nov 7;21(1):350. doi: 10.1186/s12890-021-01709-x.