Zusammenfassung
Medikamente sind eine bekannte Ursache für eine Lungeneosinophilie. Es gibt einige Fallberichte über Patienten mit akuter eosinophiler Pneumonie in Verbindung mit Kokainkonsum. Veränderte Gewohnheiten des Heroinkonsums, mit Verschiebung vom intravenösen Gebrauch zum Heroinrauchen/Inhalation, können zu häufigerem Auftreten einer Heroin-verursachten Lungeneosinophilie führen. Berichtet wird der Fall eines Patienten, der ungefähr 10 Jahre lang Heroin inhaliert hatte. Er präsentierte sich mit Fieber, Husten, Atemnot und pleuritischem Schmerz in der Brust. Die Röntgenuntersuchung des Thorax zeigte einen einseitigen Pleuraerguß mit segmentaler Atelektase. Die Analyse des Pleuraergusses und der bronchoalveolaren Lavage zeigte eine signifikante Eosinophilie, womit die Diagnose einer eosinophilen Pneumonie gegeben war. Durch Heroinabstinenz und Kortikosteroidbehandlung konnte eine schnelle Genesung erzielt werden.
Summary
Drugs are known to be a cause of pulmonary eosinophilia and several case reports of acute eosinophilic pneumonia associated with the use of cocaine have been reported. The changing pattern of heroin use, with a shift from intravenous use to smoking/inhalation of the substance, may lead to increased prevalence of heroin-induced pulmonary eosinophilia. We report on a case of a patient who had been inhaling heroin for about ten years. He presented with fever, cough, dyspnea and pleuritic chest pain. Chest radiograph showed unilateral pleural effusion with segmental atelectasis. Examination of pleuritic fluid aspirate and bronchoalveolar lavage fluid revealed significant eosinophilia. He was diagnosed with acute eosinophilic pneumonia. Rapid remission was achieved after heroin abstinence and initiation of corticosteroid treatment.
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Tsapas, A., Paletas, K., Vlachaki, E. et al. Eosinophilic pneumonia associated with heroin inhalation: a case report. Wien Klin Wochenschr 120, 178–180 (2008). https://doi.org/10.1007/s00508-008-0938-0
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DOI: https://doi.org/10.1007/s00508-008-0938-0