Flecainide-associated pneumonitis

Akoun, G; Cadranel, J.; Israel-Biet, Dominique; S, Gauthier-Rahman

doi:10.1016/0140-6736(91)93367-i

Cited by 14 publications

(9 citation statements)

References 3 publications

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“…Three cases of documented flecainide-induced pneumonitis have been published [4, 5, 6]. The first case was a patient treated with flecainide (200 mg daily) and amiodarone, who presented diffuse infiltrative lung disease with lymphocytic alveolitis.…”

Section: Discussionmentioning

confidence: 99%

“…The first case was a patient treated with flecainide (200 mg daily) and amiodarone, who presented diffuse infiltrative lung disease with lymphocytic alveolitis. The outcome was favorable after flecainide withdrawal, despite the continuation of amiodarone treatment [4]. A cell-mediated immunological reaction to flecainide was suspected.…”

Section: Discussionmentioning

confidence: 99%

“…Dizziness, visual disturbances and headache are the most frequently reported extracardiac adverse effects of flecainide [3]. Although dyspnea and chest pain were reported in 4–7% of patients in the first studies on flecainide safety [3], the incidence of lung toxicity is probably much lower, because only three cases of flecainide-associated pneumonitis have been published since its release in 1983 [4, 5, 6]. We report two patients who developed diffuse infiltrative lung disease during flecainide therapy with a favorable outcome.…”

Section: Introductionmentioning

confidence: 99%

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Diffuse Infiltrative Lung Disease Associated with Flecainide

Pesenti

Lauque²,

D'aste³

et al. 2002

Respiration

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We present two patients who developed subacute diffuse infiltrative lung disease while receiving flecainide for supraventricular arrhythmia. They had bilateral subpleural lung opacities on computed tomography. Bronchoalveolar lavage revealed increased numbers of lymphocytes and eosinophils, and a low CD4/CD8 ratio. Nonspecific interstitial pneumonia was documented by open lung biopsy in patient 1. The outcome was favorable after flecainide withdrawal and prednisone treatment. Drug-induced pneumonitis should be suspected in patients treated with flecainide presenting with subacute diffuse infiltrative lung disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diffuse Infiltrative Lung Disease Associated with Flecainide

Pesenti

Lauque²,

D'aste³

et al. 2002

Respiration

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“…Lung toxicity has also been reported for tocainide and flecainide, two other widely used antiarrhythmic agents. In particular, very rare cases of ARDS have been reported for flecainide [45], while cases of acute interstitial pneumonitis (IP) and pulmonary fibrosis [46] have been reported for tocainide.…”

Section: Cardiovascular Drugsmentioning

confidence: 99%

HRCT Patterns of Drug-Induced Interstitial Lung Diseases: A Review

et al. 2020

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Interstitial Lung Diseases (ILDs) represent a heterogeneous group of pathologies, which may be related to different causes. A low percentage of these lung diseases may be secondary to the administration of drugs or substances. Through the PubMed database, an extensive search was performed in the fields of drug toxicity and interstitial lung disease. We have evaluated the different classes of drugs associated with pulmonary toxicity. Several different high resolution computed tomography (HRCT) patterns related to pulmonary drug toxicity have been reported in literature, and the most frequent ILDs patterns reported include Nonspecific Interstitial Pneumonia (NSIP), Usual Interstitial Pneumonia (UIP), Hypersensitivity Pneumonitis (HP), Organizing Pneumonia (OP), Acute Respiratory Distress Syndrome (ARDS), and Diffuse Alveolar Damage (DAD). Finally, from the electronic database of our Institute we have selected and commented on some cases of drug-induced lung diseases related to the administration of common drugs. As the imaging patterns are rarely specific, an accurate evaluation of the clinical history is required and a multidisciplinary approach—involving pneumologists, cardiologists, radiologists, pathologists, and rheumatologists—is recommended.

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“…Concerning cytotoxic drugs, the LMI was positive in patients with methotrexate-induced pneumonitis, while it was negative in patients receiving methotrexate without lung disease.31 This test was also positive in amiodarone and flecainide pneumonitis. 32, 33 Lung function tests showed a nonspecific restrictive ventilatory defect which disappeared after drug with-ible if treated aggressively, however, this was unsuccessful in our patient.44 Vincristine rarely causes pulmonary injury except when used in combination with other cytotoxic Two children were treated with BCNU. O'Driscoll described the incidence and characteristics of BCNUinduced pneumonitis in 17 children5 of whom 2 died within 3 years of treatment and 4 after a symptom-free intervals of 7 to 12 years.…”

Section: 36mentioning

confidence: 70%

Cytotoxic drug‐induced pulmonary disease in infants and children

Fauroux

Meyer-Milsztain

Boccon‐Gibod

et al. 1994

Pediatric Pulmonology

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The increased survival rate of malignant diseases due to more aggressive treatments contributes to the occurrence of drug-induced pulmonary diseases (DIPD). We reviewed, retrospectively over a 10-year period, 15 children (8 girls) who presented a DIPD. Their mean age was 9 years (range, 1 to 17 years), with an underlying malignant disease in 14 (9 leukemias). Three typical patterns have emerged from this analysis: (1) acute hypersensitivity lung disease caused by methotrexate (in 6 patients) or azathioprine (in 1 patient). This acute syndrome consisted of alveolar-interstitial infiltrate with a hypercellularity on bronchoalveolar lavage (BAL) (mean, 714,286 cells/mL; range, 180,000-2,940,000 cells/mL) and an increase of lymphocyte counts (mean, 39%; range 11-64%) with predominantly CD8-suppressor/cytotoxic lymphocytes. Inhibition of leukocyte migration or leukocyte aggregation in the presence of low drug concentrations was positive in the 5 cases tested. Lung function tests showed a restrictive pattern and the outcome of DIPD was always favorable. (2) Chronic pneumonitis/fibrosis was seen in 6 patients who received a variable association of cyclophosphamide (3 patients), bleomycin (2 patients), BCNU (2 patients), and melphalan (1 patient). Symptoms of an alveolar-interstitial pneumonitis developed progressively. BAL showed a moderate increase of total cell numbers (mean, 495,000 cells/mL; range, 150,000-900,000 cells/mL). Lung function tests showed a restrictive pattern. Despite corticosteroid treatment in 4 children, one died after bleomycin lung injury and 2 had functional lung impairment. (3) Noncardiogenic pulmonary edema occurred in 2 patients with leukemia treated with recombinant interleukin II. BAL showed hypercellularity and outcome was rapidly favorable.(ABSTRACT TRUNCATED AT 250 WORDS)

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Flecainide-associated pneumonitis

Cited by 14 publications

References 3 publications

Diffuse Infiltrative Lung Disease Associated with Flecainide

Diffuse Infiltrative Lung Disease Associated with Flecainide

HRCT Patterns of Drug-Induced Interstitial Lung Diseases: A Review

Cytotoxic drug‐induced pulmonary disease in infants and children

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