Sertraline-induced hypersensitivity pneumonitis

Virdee, Gursharan; Bleasdale, John; Ikramullah, Mohammed; Graham-Clarke, Emma

doi:10.1136/bcr-2019-230724

Cited by 5 publications

(2 citation statements)

References 10 publications

(15 reference statements)

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“…A few case reports of sertraline-induced ILD exist. One describes a 47-year-old female developing sertraline-induced hypersensitivity pneumonitis, responding rapidly to drug cessation and steroid therapy [ 6 ]. Another describes a 40-year-old female developing eosinophilic pneumonia just 7 days after commencing sertraline [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Sertraline as a rare cause of interstitial lung disease

Lepore¹,

Campbell

2021

Oxford Medical Case Reports

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Sertraline, a selective serotonin reuptake inhibitor, is commonly prescribed for the treatment of moderate-to-severe depression. We report a case of a 36-year-old male taking sertraline for 7 weeks prior to developing a dry cough, pleuritic chest pain, hypoxia and diffuse ground-glass attenuation with mediastinal lymphadenopathy on imaging. No infectious aetiology was identified and multiple causes of pneumonitis excluded. Sertraline-induced interstitial lung disease was subsequently diagnosed. Sertraline was discontinued and treatment commenced with a weaning course of oral dexamethasone, leading to a rapid reduction in oxygen requirement and successful discharge. Given the increasing prevalence of selective serotonin reuptake inhibitor use, it is vital that medical professionals can recognize sertraline as a rare, albeit potentially life-threatening, cause of interstitial lung disease—allowing for the rapid diagnosis and appropriate management of this condition.

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Section: Discussionmentioning

confidence: 99%

Sertraline as a rare cause of interstitial lung disease

Lepore¹,

Campbell

2021

Oxford Medical Case Reports

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“…One thing to be aware of is hypersensitive pneumonia (HP), a diffuse interstitial lung disease caused by sensitization of susceptible individuals to repeated and prolonged exposure to large amounts of antigen (83). It is often associated with exposure to external allergens (such as poultry dust, mould and tobacco) and medications including cytotoxins (such as MTX) and antiepileptic drugs (such as carbamazepine) (84). Some HP patients may recover, while others develop pulmonary fibrosis, which may be related to the microbiota of the lower respiratory tract (85).…”

Section: Toxic Effects Of Mtxmentioning

confidence: 99%

Pharmacomicrobiology of Methotrexate in Rheumatoid Arthritis: Gut Microbiome as Predictor of Therapeutic Response

et al. 2021

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Rheumatoid arthritis (RA) is a disabling autoimmune disease with invasive arthritis as the main manifestation and synovitis as the basic pathological change, which can cause progressive destruction of articular cartilage and bone, ultimately leading to joint deformity and loss of function. Since its introduction in the 1980s and its widespread use in the treatment of RA, low-dose methotrexate (MTX) therapy has dramatically changed the course and outcome of RA treatment. The clinical use of this drug will be more rational with a better understanding of the pharmacology, anti-inflammatory mechanisms of action and adverse reaction about it. At present, the current clinical status of newly diagnosed RA is that MTX is initiated first regardless of the patients’ suitability. But up to 50% of patients could not reach adequate clinical efficacy or have severe adverse events. Prior to drug initiation, a prognostic tool for treatment response is lacking, which is thought to be the most important cause of the situation. A growing body of studies have shown that differences in microbial metagenomes (including bacterial strains, genes, enzymes, proteins and/or metabolites) in the gastrointestinal tract of RA patients may at least partially determine their bioavailability and/or subsequent response to MTX. Based on this, some researchers established a random forest model to predict whether different RA patients (with different gut microbiome) would respond to MTX. Of course, MTX, in turn, alters the gut microbiome in a dose-dependent manner. The interaction between drugs and microorganisms is called pharmacomicrobiology. Then, the concept of precision medicine has been raised. In this view, we summarize the characteristics and anti-inflammatory mechanisms of MTX and highlight the interaction between gut microbiome and MTX aiming to find the optimal treatment for patients according to individual differences and discuss the application and prospect of precision medicine.

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Sertraline

2020

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Sertraline-induced hypersensitivity pneumonitis

Cited by 5 publications

References 10 publications

Sertraline as a rare cause of interstitial lung disease

Sertraline as a rare cause of interstitial lung disease

Pharmacomicrobiology of Methotrexate in Rheumatoid Arthritis: Gut Microbiome as Predictor of Therapeutic Response

Sertraline

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