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Drug-induced pneumonitis following the administration of laninamivir octanoate: The first two reported cases

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  • Drug-induced pneumonitis following the administration of laninamivir octanoate: The first two reported cases

    J Infect Chemother. 2019 Jun 6. pii: S1341-321X(19)30140-0. doi: 10.1016/j.jiac.2019.05.008. [Epub ahead of print]
    Drug-induced pneumonitis following the administration of laninamivir octanoate: The first two reported cases.

    Ogawa T1, Tanaka K2, Ohgino K3, Omori N3, Betsuyaku T4, Sayama K3.
    Author information

    Abstract

    Laninamivir, a neuraminidase inhibitor (NAI), has been used for the treatment and prophylaxis of influenza A/B. To date, pneumonia has not been reported as an adverse effect of NAIs. Here, we report the first 2 cases of drug-induced pneumonitis after the administration of laninamivir octanoate (LO), a pro-drug of laninamivir. Case 1 reports a 20-year-old healthy woman presenting with LO-induced pneumonitis so severe that it was necessary for endotracheal intubation and administration of mechanical ventilator support. Steroids were used for the treatment of pneumonitis and rapid improvement was observed. Case 2 reports a 35-year-old healthy woman presenting with less severe LO-induced pneumonitis that improved without any treatment. In both cases, drug-induced lymphocyte stimulation tests (DLSTs) were positive. In the bronchoalveolar lavage (BAL) fluid, the proportion of eosinophils to lymphocytes was higher in Case 1. Conversely, the proportion of lymphocytes to eosinophils was higher in Case 2. Collectively, we determined 3 clinical issues: (1) LO could cause pneumonia; (2) BAL and DLST could be helpful in the diagnosis of LO-induced pneumonitis; and (3) LO-induced pneumonia could become severe, though steroids were effective in improving it.
    Copyright 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.


    KEYWORDS:

    Drug-induced pneumonitis; Influenza; Laninamivir; Laninamivir octanoate; Neuraminidase inhibitor

    PMID: 31178281 DOI: 10.1016/j.jiac.2019.05.008
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