Furazolidone-induced interstitial lung disease: a case series analysis and literature review
10.3760/cma.j.cn114015-20230912-00677
- VernacularTitle:呋喃唑酮诱导的间质性肺疾病：病例系列分析及文献复习
- Author:
Yejin ZHANG
1
;
Huayong LIU
;
Lixia XIE
Author Information
1. 华中科技大学协和深圳医院药学部，深圳 518000
- Publication Type:Journal Article
- Keywords:
Furazolidone;
Lung diseases, interstitial;
Drug-related side effects and adverse reactions;
Helicobacter pylori
- From:
Adverse Drug Reactions Journal
2024;26(3):138-144
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics of interstitial lung disease (ILD) caused by furazolidone.Methods:Clinical data of 7 patients with furazolidone-related ILD (hospital cases) hospitalized in the Department of Respiratory Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital from April 1, 2022 to April 1, 2023 were collected and retrospectively analyzed, including patient basic information, medication treatments, and characteristics, treatment and outcomes of ILD. Relevant databases at home and abroad were searched, and case reports of furazolidone-related ILD (literature cases) were collected. The basic information of literature, involving patient information, indications and treatment doses of furazolidone, as well as the latentperiod, main symptoms, laboratory tests, and auxiliary examination related to ILD was descriptively analyzed.Results:Among the 7 hospital cases, 2 were males and 5 were females, with a median age of 34 years. All patients were treated with a bismuth quadruple therapy containing furazolidone (0.2 g, once daily) due to Helicobacter pylori (HP)-associated gastritis. The median time from taking medicine to the onset of clinical symptoms of interstitial lung disease was 10 days. All patients had fever, and 6 had respiratory symptoms (dry cough, dyspnea, chest pain, etc.). ILD changes were found in all patients in their chest imaging, and pleural effusion was also found in 1 patient. Seven patients had normal eosinophil counts, and 1 had mild hypoxemia. The severity of ILD was grade 2 in 6 patients and grade 3 in 1 patient. All 7 patients stopped using furazolidone, and 4 received glucocorticoids additionally. After the hospitalization of 3-10 days, all the 7 patients recovered. Eighteen literature cases of furazolidone-related ILD were retrieved, of which 15 were from China and 14 used furazolidone to treat HP infection. The time from taking medicine to the onset of clinical symptoms was 2-14 days, and the time was >7 days in 13 patients. Sixteen patients had fever, 14 had respiratory symptoms, and 1 had respiratory failure. The peripheral blood eosinophil count or percentage increased in 12 patients. All 18 patients stopped using furazolidone; 7 received glucocorticoids and 1 received ventilator assisted ventilation. All patients recovered or were improved. ILD recured in rechallenge with furazolidone in 2 patients, and 1 of them had a strong positive reaction to furazolidone in vitro lymphocyte transformation test. Conclusions:ILD is a rare adverse reaction of furazolidone, main manifests as fever and respiratory symptoms and mostly occurs 7 days after furazolidone treatment. Early detection and timely withdrawal of furazolidone generally lead to a good prognosis.
