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  • Title: [A case of drug-induced pneumonia caused by propiverine: follow-up drug lymphocyte stimulation test useful for identification of the suspected drug].
    Author: Nakayama M, Bando M, Hosono T, Yamasawa H, Ohno S, Sugiyama Y.
    Journal: Nihon Kokyuki Gakkai Zasshi; 2008 Apr; 46(4):336-40. PubMed ID: 18517000.
    Abstract:
    A 75-year-old woman presented with general malaise and exertional dyspnea one week after the administration of propiverine, a urination-improving drug, with a diagnosis of neurogenic bladder. Her chest X-ray film and high-resolution computed tomography (HRCT) revealed bilateral, non-segmental, ground-glass opacities with partial consolidation and cord-shaped shadows. Bronchoalveolar lavage (BAL) fluid suggested an increase in the ratio of lymphocytes. A drug lymphocyte stimulation test (DLST) for propiverine showed a negative reaction 2 weeks after onset; however, a positive reaction was noted after a further 2 weeks. After the discontinuation of propiverine, the symptoms and imaging findings markedly improved. The clinical course suggested drug-induced pneumonia caused by propiverine. Considering the risk of additional administration and the necessity of subsequent prescription, drug provocation test was not performed. No study has reported propiverine-related lung injuries; however, as this agent is frequently prescribed in elderly patients, the possibility of drug-induced pneumonia must be considered.
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