Captopril, an Angiotensin-Converting Enzyme Inhibitor, Induced Pulmonary Infiltration with Eosinophilia

In this study, we investigated the association between the drug-induced pulmonary infiltration with eosinophilia (PIE) syndrome in a patient with hypertension and the angiotensin-converting enzyme inhibitor (ACE-I) captopril. Although the patient developed diffuse lung field infiltrates accompanied...

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Published inInternal Medicine Vol. 35; no. 2; pp. 142 - 145
Main Authors WATANABE, Kouki, NISHIMURA, Kazutaka, SHIODE, Masahiro, SEKIYA, Michihito, IKEDA, Shuntarou, INOUE, Yoshikazu, IWANAGA, Chiaki
Format Journal Article
LanguageEnglish
Published Tokyo The Japanese Society of Internal Medicine 1996
Japanese Society of Internal Medicine
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Abstract In this study, we investigated the association between the drug-induced pulmonary infiltration with eosinophilia (PIE) syndrome in a patient with hypertension and the angiotensin-converting enzyme inhibitor (ACE-I) captopril. Although the patient developed diffuse lung field infiltrates accompanied by productive cough and striking peripheral eosinophilia, these symptoms disappeared after termination of the administration of captopril, pronase and cephalexine. Furthermore, the results of the peripheral lymphocyte stimulation test, skin patch test and provocation test under informed consent showed a positive reaction only for captopril. Therefore, this patient was diagnosed as captopril-induced PIE syndrome. (Internal Medicine 35: 142-145, 1996)
AbstractList In this study, we investigated the association between the drug-induced pulmonary infiltration with eosinophilia (PIE) syndrome in a patient with hypertension and the angiotensin-converting enzyme inhibitor (ACE-I) captopril. Although the patient developed diffuse lung field infiltrates accompanied by productive cough and striking peripheral eosinophilia, these symptoms disappeared after termination of the administration of captopril, pronase and cephalexine. Furthermore, the results of the peripheral lymphocyte stimulation test, skin patch test and provocation test under informed consent showed a positive reaction only for captopril. Therefore, this patient was diagnosed as captopril-induced PIE syndrome. (Internal Medicine 35: 142-145, 1996)
In this study, we investigated the association between the drug-induced pulmonary infiltration with eosinophilia (PIE) syndrome in a patient with hypertension and the angiotensin-converting enzyme inhibitor (ACE-I) captopril. Although the patient developed diffuse lung field infiltrates accompanied by productive cough and striking peripheral eosinophilia, these symptoms disappeared after termination of the administration of captopril, pronase and cephalexine. Furthermore, the results of the peripheral lymphocyte stimulation test, skin patch test and provocation test under informed consent showed a positive reaction only for captopril. Therefore, this patient was diagnosed as captopril-induced PIE syndrome.
Author SEKIYA, Michihito
WATANABE, Kouki
SHIODE, Masahiro
NISHIMURA, Kazutaka
IKEDA, Shuntarou
INOUE, Yoshikazu
IWANAGA, Chiaki
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  organization: The Division of Internal Medicine, National Minamifukuoka Chest Hospital
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Keywords Case study
Respiratory disease
Enzyme
Peptidyl-dipeptidase A
Toxicity
Eosinophilic pneumonia
Enzyme inhibitor
Hydrolases
Peptidyl-dipeptidases
Proteinases
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References 1) Sesoko S, Kaneko K. Cough associated with the use of captopril. Arch Intern Med 145: 1524, 1985.
9) Rosenow EC III, Myers JL, Swensen SJ, Pisani RJ. Drug-induced pulmonary disease: An update. Chest 102: 239, 1992.
6) Paronetto F, Popper H. Lymphocyte stimulation induced by halothane in patients with hepatitis following exposure to halothane. N Engl J Med 283: 277, 1970.
10) Cooper JAD Jr, White DA, Matthay RA. State of art: Drug-induced pulmonary disease. Am Rev Respir Dis 133: 486, 1986.
4) Lipworth BJ, McMurray JJ, Clark RA, Struthers AD. Development of persistent late onset asthma following treatment with captopril. Eur Respir J 2: 586, 1989.
8) Janicki BW, Goldstein RA. Immunologic studies of nitrofurantoininduced lung disease. Am Thoracic Society 109: 732, 1974.
7) Regoli D, Barabe J. Pharmacology of bradykinin and related kinins. Pharmacol Rev 32: 1, 1980.
2) Semple PF, Herd GW. Cough and wheeze caused by inhibitors of angiotensin-converting enzyme. N Engl J Med 314: 61, 1986.
5) Schatz PL, Mesologites D, Hyun J, Smith GJW, Lahiri B. Captopril-induced hypersensitivity lung disease. An immune-complex mediated phenomenon. Chest 95: 685, 1989.
3) Kaufman J, Schmitt S, Barnard J, Busse W. Angiotensin-converting enzyme inhibitors in patients with bronchial responsiveness and asthma. Chest 101: 922, 1992.
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SubjectTerms Angiotensin-Converting Enzyme Inhibitors - adverse effects
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Biological and medical sciences
Biopsy
bronchoalveolar lavage
Bronchoalveolar Lavage Fluid
Captopril - adverse effects
Captopril - therapeutic use
Drug toxicity and drugs side effects treatment
Female
Humans
Hypertension - drug therapy
Lung - diagnostic imaging
Lung - pathology
Lymphocyte Activation
lymphocyte stimulation test
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Pulmonary Eosinophilia - chemically induced
Pulmonary Eosinophilia - diagnosis
Radiography
skin patch test
Skin Tests
Syndrome
Toxicity: respiratory system, ent, stomatology
transbronchial lung biopsy
Title Captopril, an Angiotensin-Converting Enzyme Inhibitor, Induced Pulmonary Infiltration with Eosinophilia
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