Duloxetine Induced Interstitial Lung Disease – A Novel Case Report
Notice bibliographique
Résumé
Abstract Introduction: Duloxetine is commonly prescribed as an antidepressant. Here, we report the first case of duloxetine-induced non-eosinophilic interstitial lung disease (ILD). Case Report: A 71-year-old female presented with a 1-month history of cough, yellow sputum, fever, vomiting, hyporexia, and 15-pound weight loss. A computed tomography pulmonary angiogram ruled out pulmonary embolism but revealed right upper lobe (RUL) consolidation and patchy consolidations/nodules in the right middle (RML) and lower lobes (RLL) (Figure 1-A). The respiratory virus panel, sputum and blood cultures, and Legionella urinary antigen were negative. She was hospitalized, treated with antibiotics, and referred to Respirology. At her clinic visit, she had dyspnea (Medical Research Council grade 2/5) and dry cough, with resolution of other symptoms. She reported exposure to foam and bamboo in her pillow and mattress but no exposure to chemicals, fumes, molds, or dusts. Her medications included duloxetine, simvastatin, omeprazole, levothyroxine, and bisoprolol. She had no connective tissue disease symptoms, and serology was negative. Examination showed SpO₂ at 97% on room air and bibasilar fine/coarse inspiratory crackles with fine crackles in the left mid-zone. Laboratory tests revealed leukocytosis (12.3 x10⁹/L), elevated CRP (114 mg/L), and ESR (73 mm/hr). Pulmonary function tests showed restriction (FVC 72%, TLC 56%) and reduced diffusing capacity (DLCO 48%). Follow-up chest CT showed resolution of RUL and RML consolidations and new consolidations in both lower lobes (LLL) (Figure 1-B). Migratory consolidations suggested organizing pneumonia (OP), from hypersensitivity pneumonitis (foam exposure), or (drug-induced) eosinophilic pneumonia (EP) due to duloxetine versus simvastatin. Bronchoalveolar lavage (BAL) from the LLL was negative for infections but showed neutrophilia (53%), eosinophilia (23%), and lymphocytosis (20%), suggesting EP and/or OP likely related to drug-induced ILD (DI-ILD). A second BAL with transbronchial lung biopsies showed mild neutrophilia (7%) and eosinophilia (4%), moderate numbers of intra-alveolar foamy macrophages and mild interstitial inflammation including lymphocytes and few eosinophils. Findings were not typical of either OP or EP. She was diagnosed with possible DI-ILD due to duloxetine that had been started a year prior, rather than due to simvastatin, which she had taken for many years; thus, duloxetine was discontinued. Following duloxetine discontinuation, she reported complete resolution of symptoms and chest CT showed complete resolution of abnormalities (Figure 1-C). Discussion: Duloxetine has only been associated with DI-ILD in one case report, diagnosed with eosinophilic pneumonia. We report here a case of non-eosinophilic DI-ILD due to duloxetine, which fully resolved after drug discontinuation.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».