Coronary stent implantation links to the occurrence of eosinophilia and interstitial pneumonia: a case report and systematic review

• Published in: BMC pulmonary medicine Vol. 24; no. 1; pp. 281 - 8
• Main Authors: Zhang, Fuyun, Wang, Wei, Zhu, Yingwei, Mao, Yimin, Wang, Tongsheng, Gao, Pengfei
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.06.2024; BioMed Central; BMC
• Subjects: Aged; Alloys; Auscultation; Bacterial pneumonia; Blood; Bronchiectasis; Cardiology; Cardiovascular disease; Case Report; Case reports; Coatings; Cobalt; Complications and side effects; Computed tomography; Consciousness; Coronary artery; Corticosteroids; Cough; CT imaging; Development and progression; Drug delivery; Drug-eluting stents; Drug-Eluting Stents - adverse effects; Dyspnea; Eosinophil; Eosinophilia; Fever; Heart attacks; Humans; Hyperthermia; Implants; Interstitial pneumonia; Leukocytes; Leukocytes (eosinophilic); Lung Diseases, Interstitial; Lungs; Male; Medical imaging; Mortality; Oral administration; Paclitaxel; Patients; Percutaneous Coronary Intervention - adverse effects; Pneumonia; Pulmonary fibrosis; Rapamycin; Restenosis; Sirolimus - adverse effects; Stent (Surgery); Stents; Steroids; Systematic review; Thyroid gland; Ticagrelor; Tomography, X-Ray Computed; Systematic review; Case report; Interstitial pneumonia; Eosinophil; Drug-eluting stents
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-024-03101-x

Rapamycin has been extensively utilized for coating coronary artery stents to reduce the occurrence of restenosis, yet there has been limited research on the potential harms of rapamycin-eluting stents. Herein, We report a case of eosinophilia and interstitial pneumonia caused by a cobalt-based alloy stent eluted with rapamycin. The patient was admitted due to fever, cough, and expectoration symptoms. Previously, the patient had undergone a procedure of percutaneous coronary stent implantation in our hospital's cardiology department, which led to a gradual rise in blood eosinophil count. This time, the eosinophil count was higher than the previous admission. A chest CT scan revealed multiple flocculent density increases in both lungs and bronchiectasis. The rapamycin-eluting stents may have caused eosinophilia and interstitial pneumonia, which improved after administering corticosteroids. A systematic review of relevant literature was conducted to summarize the characteristics of interstitial pneumonia caused by drug-eluting stents. Paclitaxel, everolimus, zotarolimus, and rapamycin are the types of drugs that can lead to drug-eluting stents, and because of the rarity of their onset, clinical doctors must be precise and prompt in diagnosing suspected cases to avoid misdiagnosis and delayed treatment.