A Case of Bucillamine-induced Interstitial Pneumonia with Positive Lymphocyte Stimulation Test for Bucillamine Using Bronchoalveolar Lavage Lymphocytes

Yoshinobu Saito; Takahito Nei; Shinji Abe; Jiro Usuki; Arata Azuma; Tomoko Nakayama; Yuh Fukuda; Shoji Kudoh

doi:10.2169/internalmedicine.46.0139

CASE REPORTS

A Case of Bucillamine-induced Interstitial Pneumonia with Positive Lymphocyte Stimulation Test for Bucillamine Using Bronchoalveolar Lavage Lymphocytes

Yoshinobu Saito, Takahito Nei, Shinji Abe, Jiro Usuki, Arata Azuma, Tomoko Nakayama, Yuh Fukuda, Shoji Kudoh

Author information

Yoshinobu Saito
Department of Internal Medicine, Divisions of Pulmonary Medicine, Infectious Diseases, and Oncology, Nippon Medical School
Takahito Nei
Department of Internal Medicine, Divisions of Pulmonary Medicine, Infectious Diseases, and Oncology, Nippon Medical School
Shinji Abe
Department of Internal Medicine, Divisions of Pulmonary Medicine, Infectious Diseases, and Oncology, Nippon Medical School
Jiro Usuki
Department of Internal Medicine, Divisions of Pulmonary Medicine, Infectious Diseases, and Oncology, Nippon Medical School
Arata Azuma
Department of Internal Medicine, Divisions of Pulmonary Medicine, Infectious Diseases, and Oncology, Nippon Medical School
Tomoko Nakayama
Department of Analytic Human Pathology, Nippon Medical School
Yuh Fukuda
Department of Analytic Human Pathology, Nippon Medical School
Shoji Kudoh
Department of Internal Medicine, Divisions of Pulmonary Medicine, Infectious Diseases, and Oncology, Nippon Medical School

Keywords: bucillamine, interstitial pneumonia, drug lymphocyte stimulation test, bronchoalveolar lavage

JOURNAL OPEN ACCESS

2007 Volume 46 Issue 20 Pages 1739-1744

DOI https://doi.org/10.2169/internalmedicine.46.0139

Details

Abstract

A 64-year-old woman with rheumatoid arthritis and treated with bucillamine presented with a productive cough. No obvious infiltration was detected in chest radiography, but CT revealed patchy ground glass opacities in bilateral lung fields. Her serum KL-6 level was elevated and transbronchial lung biopsy showed interstitial pneumonia. Drug lymphocyte stimulation test (DLST) for bucillamine was negative for blood lymphocytes, but positive for bronchoalveolar lavage (BAL) lymphocytes. The pneumonitis improved after the cessation of bucillamine. We therefore made a diagnosis of bucillamine-induced interstitial pneumonia. DLST with BAL lymphocytes is thus suggested to be useful for such diagnoses.

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