Chest
Bronchoalveolar Lavage Cell Data in 19 Patients with Drug-Associated Pneumonitis (Except Amiodarone)
Section snippets
Study Populations
Diagnosis of drug-associated pneumonitis was established by the following criteria. (1) Patients had been receiving drug treatment on a more or less long-term basis prior to the onset of lung disorders (Table 1). (2) New bilateral infiltrates appeared on chest roentgenogram. (3) There was no exposure to environmental agents known to be liable to induce lung disorders. (4) No other cause of interstitial pneumonitis was found after repeated clinical and biologic tests. Examination of sputum and
BAL Cell Abnormalities at Hospital Admission
Table 2 shows BAL cell individual data from our 19 patients. When compared with data from healthy subjects, total cell count was almost normal and macrophage count mean value was normal in absolute number and lower in proportion, given the increase in other cell types. When calculated in proportion as well as in absolute number, mean values of lymphocytes and neutrophils were found higher than those from controls, whereas the rise in eosinophil mean value was present in proportion, although it
DISCUSSION
In this series of 19 cases, 13 drugs listed in Table 1 were likely to be responsible for pneumonitis.
In the literature,6 pulmonary toxicity due to five of the 13 drugs incriminated (bleomycin, methotrexate, nitrofurantoin, gold salts, and nilutamide) has already been mentioned in 26 BAL-investigated cases (Table 4). We present herein data about BAL from nine patients with pneumonitis associated with one of these five drugs; six of these nine cases have been published previously.7, 8, 9, 10
In
ACKNOWLEDGMENTS
We are grateful to Els Cauverien for helpful discussion and Martine Dabancourt for secretarial assistance.
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