Abstract
The patient was a 69-year-old woman who had undergone maintenance hemodialysis (HD) since July 1996. At the end of March 2000, one month after the administration of losartan for the treatment of hypertension, she developed a high fever, loss of appetite, and general fatigue. Physical examination and laboratory findings were unremarkable, but routine chest X-ray showed an infiltration in the bilateral lung, accompanied by an increase in the number of eosinophils in the peripheral blood. She was admitted to our hospital on April 7th for further examination of high fever and abnormal shadow on chest X-ray.
Under the tentative diagnosis of drug-induced pneumonia, losartan was discontinued, and prednisolone was given orally. Bronchoscopy was performed on the 5th hospital day, and disclosed an increase in the percentage of eosinophil in the bronchoalveolar lavage. Her high fever and abnormal findings on chest X-ray resolved following prednisolone therapy. Although a drug-lymphocyte stimulation test (DLST) for losartan was negative, a diagnosis of eosinophilic pneumonia induced by losartan was made.
We report the first case that developed eosinophilic pneumonia associated with losartan treatment. Clinicians must consider the potential adverse effects of angiotensin II recepter blocker (ARB), because treatment with ARB is expected to increase.
