Drug-induced pleural disease
Section snippets
Minoxidil
Minoxidil is an antihypertensive agent that is used to treat recalcitrant hypertension. It acts as a peripheral vasodilator and its major side effects are excessive hair growth, nausea, thrombocytopenia, leukopenia, breast tenderness, and skin rash [4]. The drug has been associated with the development of fluid in the pericardial and pleural space [5], [6]. Webb and Whale [6] reported a case of bilateral pleural effusions in a patient who received minoxidil for 3 months. Thoracentesis and
Sodium morrhuate/absolute alcohol
Sodium morrhuate and absolute alcohol are sclerotherapeutic agents that are used in the treatment of esophageal varices; they are the drugs that most commonly cause pleural effusions. The reported incidence of pleural effusions with the use of sodium morrhuate is 40% to 50% and with absolute alcohol, 19% [30]. Pleural effusions that are associated with sclerotherapeutic agents occur mostly on the right; however, they may occur on the left or bilaterally, depending on the site of injection. The
Methysergide
Methysergide is a serotonin antagonist that is used to treat migraine headaches. Its common adverse side effects include alopecia, dermatitis, nausea, coronary, and valvular heart disease. The development of fibrosing mediastinitis and retroperitoneal fibrosis is well-documented in the medical literature [31]. With increased use during the 1960s, multiple reports of fibrosis of the pleura, lung, endocardium, and pericardium were described [32], [33], [34], [35], [36], [37], [38], [39].
Bleomycin
Bleomycin, an antitumor antimicrobial agent that is derived from fermentation of Streptomyces verticillus, is used often in the treatment of head and neck carcinoma, testicular carcinoma, and Hodgkin's and non-Hodgkin's lymphoma. It has been used rarely as a sclerosing agent in the management of recurrent pleural effusions. Adverse pleuropulmonary reactions occur in approximately 6% to 10% of patients and are associated with a mortality rate of 1.6% [45], [46]. The most common presentation of
Pleural fluid eosinophilia
Pleural fluid eosinophilia (defined as >10% of nucleated cells) is a nonspecific finding for drug-induced pleural disease. Six of the eight drugs that are known to cause pleural fluid eosinophilia have been identified in the medical literature and are discussed in detail here.
Other drugs
In the following section, we discuss a variety of agents, that have been reported to be associated with pleuropulmonary disease.
Drug-induced lupus pleuritis
Since the initial description of a lupuslike illness following treatment with sulfadiazine in 1945 by Hoffman [104], more than 80 drugs have been reported to cause a lupuslike reaction or exacerbate pre-existing lupus. Table 2 provides a list of common pharmacologic agents that are implicated. Only a few drugs have a strong association with drug-induced lupus (DIL); they include procainamide, hydralazine, chlorpromazine, isoniazid, d-penicillamine, methyldopa, and quinidine [105]. Only
Summary
Drug-induced pleural disease is uncommon and less known to clinicians than drug-induced parenchymal lung disease. Pleural reactions from drugs manifest as pleural effusions, pleural thickening, or pleuritic chest pain, and may occur in the absence of parenchymal infiltrates. The clinician should be cognizant of the possibility of a drug-induced pleural reaction. A detailed drug history, temporal relationship between symptom onset and initiation of therapy, and pleural fluid eosinophilia should
References (110)
Drug-induced pleural disease
Clin Chest Med
(1998)- et al.
Drugs and the pleura
Chest
(1999) - et al.
Respiratory disease associated with practolol therapy
Lancet
(1977) Progressive pleural thickening during oxprenolol therapy
Br J Dis Chest
(1979)- et al.
Pulmonary toxicity of amiodarone
Chest
(1984) - et al.
Amiodarone pulmonary toxicity presenting as bilateral exudative pleural effusions
Chest
(1987) - et al.
Pneumonitis with pleural and pericardial effusion and neuropathy during amiodarone therapy
Int J Cardiol
(1985) - et al.
Amiodarone pulmonary toxicity: report of two cases associated with rapidly progressive fatal adult respiratory distress syndrome after pulmonary angiography
Mayo Clin Proc
(1985) - et al.
Development of pleural effusion after sclerotherapy with absolute alcohol
Gastrointest Endosc
(1993) - et al.
Pleural effusions and fibrosis secondary to sansert administration
Ann Thorac Surg
(1973)
Pleuropulmonary changes during long-term bromocriptine treatment for Parkinson's disease
Lancet
Pleuropulmonary involvement during bromocriptine treatment
Chest
Pulmonary complications associated with combination chemotherapy programs containing bleomycin
Am J Med
Late-onset pulmonary fibrosis and chest deformity in two children treated with cyclophosphamide
J Pediatr
Eosinophilic pleuritis due to propylthiouracil
Chest
Isotretinoin-related eosinophilic pleural effusion. [letter]
Chest
Isotretinoin and eosinophilic pleural effusion
Lancet
Drug-induced bronchopulmonary pleural disease
J Allergy Clin Immunol
Lymphopenia in acute nitrofurantoin pleuropulmonary disease
J Allergy Clin Immunol
Eosinophilic pleural effusion associated due to gliclazide
Resp Med
Fever, pulmonary infiltrates, and pleural effusion following acyclovir therapy for Herpes zoster ophthalmicus
Chest
Chest roentgenography abnormalities in IL-2 recipients: incidence in correlation with clinical parameters
Chest
l -tryptophan induced cough and pleural effusion associated with the eosinophilia-myalgia syndrome
Chest
Acute eosinophilic pulmonary disease associated with the ingestion of -tryptophan containing products
Chest
Drug-induced pulmonary disease. Part I: cytotoxic drugs. Part II: non-cytotoxic drugs
Am Rev Respir Dis
Pericardial disorders during open-label study of 1,869 severely hypertensive patients treated with minoxidil
J Cardiovasc Pharmacol
Pleuropericardial effusion associated with minoxidil administration
Postgrad Med J
Interstitial pulmonary fibrosis: a new side effect of practolol
BMJ
Practolol-induced pleurisy and constrictive pericarditis
BMJ
Pleural fibrosis after practolol therapy
Thorax
Pleural effusion after practolol
Lancet
Pleural effusions after practolol
Lancet
Adverse effects of practolol
Ann Clin Res
Amiodarone pulmonary toxicity: CT findings in symptomatic patients
Radiology
Amiodarone pneumonitis: three further cases with a review of published reports
Thorax
Lung disease caused by amiodarone, a new antiarrhythmic agent
Radiology
Atypical pulmonary and neurological complications of amiodarone in the same patient
Arch Intern Med
Amiodarone pulmonary toxicity
Ann Intern Med
Pneumonitis after amiodarone therapy
Radiology
Amiodarone pulmonary toxicity
Am Heart J
Pneumonitits and pulmonary fibrosis associated with amiodarone treatment: a possible complication of a new antiarrhythmic drug
Circulation
Amiodarone pulmonary toxicity: chest radiography and CT in asymptomatic patients
Chest
Amiodarone pulmonary toxicity
Acta Cytol
Low-dose steroid therapy for prophylaxis of amiodarone-induced pulmonary infiltrates
N Engl J Med
Cardiac and pulmonary fibrosis during methysergide therapy for headache
Am J Med Sci
Fibrotic disorders associated with methysergide therapy for headache
N Engl J Med
Pleuropulmonary fibrosis following therapy with methysergide maleate: two case reports
J LA State Med Soc
Pleurisy and fibrosis of the pleura during methysergide treatment of hemicrania
Scand J Respir Dis
Pleural effusion and fibrosis during the treatment with methysergide
BMJ
Cited by (84)
Eosinophilic Pleural Effusion Induced by Paliperidone Palmitate: Case Report and Literature Review
2022, Journal of the Academy of Consultation-Liaison PsychiatryBenign Pleural Thickening, Fibrosis and Plaques
2021, Encyclopedia of Respiratory Medicine, Second EditionChest Tube
2021, A Medication Guide to Internal Medicine Tests and Procedures65 - Hypersensitivity Pneumonitis and Eosinophilic Lung Diseases
2019, Kendig's Disorders of the Respiratory Tract in ChildrenPleural effusion: An uncommon manifestation of nitrofurantoin-induced pulmonary injury
2016, Respiratory Medicine Case Reports