A case of mexiletine-induced hypersensitivity syndrome presenting as eosinophilic pneumonia

An 82-yr-old man was presented with fever and cough accompanied by generalized erythematous rash. He had taken mexiletine for 5 months, as he had been diagnosed with dilated cardiomyopathy and ventricular arrhythmia. Laboratory studies showed peripheral blood eosinophilia and elevated liver transami...

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Bibliographic Details
Published in:Journal of Korean medical science 2010, 25(1), 134, pp.148-151
Main Authors: Lee, Sang-Pyo, Kim, Sang-Heon, Kim, Tae Hyung, Sohn, Jang Won, Shin, Dong Ho, Park, Sung Soo, Yoon, Ho Joo
Format: Article
Language:English
Subjects:
Aged, 80 and over
Anti-Arrhythmia Agents - adverse effects
Arrhythmias, Cardiac - drug therapy
Cardiomyopathy, Dilated - drug therapy
Case Report
Drug Hypersensitivity - diagnosis
Drug Hypersensitivity - etiology
Exanthema - pathology
Humans
Lung - diagnostic imaging
Lung - pathology
Male
Mexiletine - adverse effects
Pulmonary Eosinophilia - chemically induced
Pulmonary Eosinophilia - diagnosis
Syndrome
Tomography, X-Ray Computed
의학일반
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Summary:An 82-yr-old man was presented with fever and cough accompanied by generalized erythematous rash. He had taken mexiletine for 5 months, as he had been diagnosed with dilated cardiomyopathy and ventricular arrhythmia. Laboratory studies showed peripheral blood eosinophilia and elevated liver transaminase levels. Chest radiographs showed multiple nodular consolidations in both lungs. Biopsies of the lung and skin lesions revealed eosinophilic infiltration. After a thorough review of his medication history, mexiletine was suspected as the etiologic agent. After discontinuing the mexiletine and starting oral prednisolone, the patient improved, and the skin and lung lesions disappeared. Subsequently, mexiletine was confirmed as the causative agent based on a positive patch test. Drug-induced hypersensitivity syndrome is a severe adverse reaction to drugs and results from treatment with anticonvulsants, allopurinol, sulfonamides, and many other drugs. Several cases of mexiletine-induced hypersensitivity syndrome have been reported in older Japanese males with manifestation of fever, rash, peripheral blood eosinophilia, liver dysfunction without other organ involvement. Here, we report a case of mexiletine-induced hypersensitivity syndrome which presented as eosinophilic pneumonia in a Korean male.
ISSN:1011-8934
1598-6357
DOI:10.3346/jkms.2010.25.1.148