Eosinophilic bronchitis presenting with only severe dry cough due to bucillamine

摘要

Although an increasing number of drugs have been implicated in the aetiology of eosinophilic pneumonia characterized by the development of pulmonary infiltrates and peripheral blood eosinophilia, eosinophilic bronchitis without alveolitis due to some pharmacologic agents has not been reported. Bucillamine [N-(2-mercapto-2-methylpropionyl)-L-cystenine] is a commonly used drug for treatment of rheumatoid arthritis in Japan, which has recently been added to the growing list of pharmacologic agents associated with infiltrative pulmonary lesions. A case of eosinophilic bronchitis induced by this drug presenting with only severe dry cough is described. The results of transbronchoscopic bronchial biopsy, a lymphocyte stimulation test, and a challenge test supported this diagnosis.