Case Reports
Strong Suspicion of Lung Toxicity Due to Riluzole
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Sellarés, S. Santos, E. Ballester, J.A. Barberà" "autores" => array:4 [ 0 => array:3 [ "preGrado" => "Dr." "nombre" => "J." "apellidos" => "Sellarés" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Santos" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Ballester" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Barberà" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906601122?idApp=UINPBA00003Z" "url" => "/15792129/0000004200000001/v1_201305150227/S1579212906601122/v1_201305150227/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Reports</span>" "titulo" => "Strong Suspicion of Lung Toxicity Due to Riluzole" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "42" "paginaFinal" => "44" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L. Borderías-Clau, J. Garrapiz-López, P. Val-Adán, C. Tordesillas-Lía, A. Alcacera-López, J.L. Bru-Martín" "autores" => array:6 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "L." "apellidos" => "Borderías-Clau" "email" => array:1 [ 0 => "lborderias@separ.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "Garrapiz-López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "P." "apellidos" => "Val-Adán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "C." "apellidos" => "Tordesillas-Lía" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "Alcacera-López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 5 => array:3 [ "nombre" => "J.L." "apellidos" => "Bru-Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Sección de Neumología, Hospital General San Jorge, Huesca, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Sección de Neurología, Hospital General San Jorge, Huesca, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Farmacia, Hospital General San Jorge, Huesca, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. L. Borderías-Clau. Sección de Neumología. Hospital San Jorge. Avda. Martínez de Velasco, 36. 22004 Huesca. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-03-29" "fechaAceptado" => "2005-04-19" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154182" "palabras" => array:4 [ 0 => "Riluzole" 1 => "Lung toxicity" 2 => "Amyotrophic lateral sclerosis" 3 => "Pulmonary infiltrates" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154183" "palabras" => array:4 [ 0 => "Riluzol" 1 => "Toxicidad pulmonar" 2 => "Esclerosis lateral amiotrófica (ELA)" 3 => "Infiltrados pulmonares" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Riluzole is a drug used in the treatment of amyotrophic lateral sclerosis. To date, reports of lung toxicity have been exceptional. We present the case of a 74-year-old man diagnosed with amyotrophic lateral sclerosis. Following 3.5 months of treatment with riluzole (Rilutek®), the patient began to present a clinical picture consisting of nonproductive cough, progressive dyspnea (even with slight exertion), weakness, and radiologic progression with the appearance of predominantly peripheral bilateral pulmonary infiltrates that did not respond to treatment with amoxicillin-clavulanic acid. Bacterial tests did not reveal the presence of germs, nor did other examinations suggest an alternative diagnosis. The patient did not resume treatment with the drug or undergo complementary procedures aimed at obtaining histologic samples. Nevertheless, the coincidence in time, lack of response to antibiotic treatment, remission of symptoms following withdrawal of the drug without initiating any other treatment except 40 mg/d of methylprednisolone for 6 days, absence of alternative diagnoses, and suggestive clinical and radiologic findings all together point to toxicity due to riluzole.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">El riluzol es un fármaco utilizado en el tratamiento de la esclerosis lateral amiotrófica. Hasta la fecha, las referen-cias de toxicidad pulmonar han sido excepcionales. Presen-tamos el caso de un varón de 74 años, diagnosticado de esclerosis lateral amiotrófica, que tras 3 meses y medio de tratamiento con riluzol (Rilutek®) inició un cuadro clínico consistente en tos no productiva, disnea progresiva hasta hacerse de pequeños esfuerzos, astenia sin fiebre y con pro-gresión radiológica con aparición de infiltrados pulmonares bilaterales de predominio periférico que no respondieron al tratamiento con amoxicilina-ácido clavulánico. Los estudios bacteriológicos realizados no demostraron gérmenes y otras exploraciones tampoco apuntaron un diagnóstico alternati-vo. El paciente no accedió a la realización de pruebas com-plementarias destinadas a la obtención de muestras histoló-gicas ni a la reintroducción del fármaco. No obstante, la coincidencia en el tiempo, la falta de respuesta al tratamiento antibiótico, la resolución del cuadro tras la retirada del fármaco sin instaurar otro tratamiento salvo 40 mg/día de metilprednisolona durante 6 días, la ausencia de diagnósti-cos alternativos y hallazgos clínicos y radiológicos indicati-vos apuntan a la toxicidad por el riluzol.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A controlled trial of riluzole in amyotrophic lateral sclerosis" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ALS/Riluzole Study Group" "etal" => false "autores" => array:3 [ 0 => "G Bensimon" 1 => "L Lacomblez" 2 => "V Meininger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199403033300901" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1994" "volumen" => "330" "paginaInicial" => "585" "paginaFinal" => "591" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8302340" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dose-ranging study of riluzole in amyotrophic lateral sclerosis" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ALS/Riluzole Study Group II" "etal" => false "autores" => array:5 [ 0 => "L Lacomblez" 1 => "G Bensimon" 2 => "PN Leigh" 3 => "P Guillet" 4 => "V Meininger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1996" "volumen" => "347" "paginaInicial" => "1425" "paginaFinal" => "1431" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8676624" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "RG Miller" 1 => "JD Mitchell" 2 => "M Lyon" 3 => "DH Moore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/14651858.CD003881.pub3" "Revista" => array:4 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2002" "volumen" => "2" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22336797" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The clinical effectiveness and cost-effectiveness of riluzole for motor neurone disease: a rapid and systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A Stewart" 1 => "J Sandercock" 2 => "S Bryan" 3 => "C Hyde" 4 => "PM Barton" 5 => "A Fry-Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Health Technol Assess" "fecha" => "2001" "volumen" => "5" "paginaInicial" => "1" "paginaFinal" => "97" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12387733" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in amyotrophic lateral sclerosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "HM Bryson" 1 => "B Fulton" 2 => "P. 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| 2024 August | 46 | 48 | 94 |
| 2024 July | 26 | 22 | 48 |
| 2024 June | 32 | 20 | 52 |
| 2024 May | 36 | 38 | 74 |
| 2024 April | 19 | 22 | 41 |
| 2024 March | 21 | 17 | 38 |
| 2024 February | 23 | 18 | 41 |
| 2024 January | 1 | 0 | 1 |
| 2023 March | 1 | 2 | 3 |
| 2023 February | 18 | 20 | 38 |
| 2023 January | 23 | 39 | 62 |
| 2022 December | 21 | 38 | 59 |
| 2022 November | 20 | 23 | 43 |
| 2022 October | 28 | 39 | 67 |
| 2022 September | 19 | 18 | 37 |
| 2022 August | 17 | 43 | 60 |
| 2022 July | 19 | 47 | 66 |
| 2022 June | 23 | 41 | 64 |
| 2022 May | 20 | 34 | 54 |
| 2022 April | 23 | 22 | 45 |
| 2022 March | 22 | 31 | 53 |
| 2022 February | 22 | 28 | 50 |
| 2022 January | 21 | 40 | 61 |
| 2021 December | 19 | 45 | 64 |
| 2021 November | 13 | 37 | 50 |
| 2021 October | 32 | 42 | 74 |
| 2021 September | 31 | 38 | 69 |
| 2021 August | 16 | 29 | 45 |
| 2021 July | 16 | 24 | 40 |
| 2021 June | 43 | 25 | 68 |
| 2021 May | 18 | 25 | 43 |
| 2021 April | 23 | 29 | 52 |
| 2021 March | 26 | 24 | 50 |
| 2021 February | 8 | 19 | 27 |
| 2021 January | 16 | 23 | 39 |
| 2020 December | 14 | 19 | 33 |
| 2020 November | 8 | 11 | 19 |
| 2020 October | 14 | 7 | 21 |
| 2020 September | 12 | 11 | 23 |
| 2020 August | 23 | 11 | 34 |
| 2020 July | 12 | 17 | 29 |
| 2020 June | 21 | 10 | 31 |
| 2020 May | 31 | 13 | 44 |
| 2020 April | 48 | 14 | 62 |
| 2020 March | 39 | 11 | 50 |
| 2020 February | 67 | 12 | 79 |
| 2020 January | 53 | 16 | 69 |
| 2019 December | 26 | 18 | 44 |
| 2019 November | 12 | 11 | 23 |
| 2019 October | 16 | 6 | 22 |
| 2019 September | 53 | 10 | 63 |
| 2019 August | 35 | 5 | 40 |
| 2019 July | 49 | 16 | 65 |
| 2019 June | 30 | 8 | 38 |
| 2019 May | 36 | 11 | 47 |
| 2019 April | 79 | 16 | 95 |
| 2019 March | 31 | 21 | 52 |
| 2019 February | 24 | 15 | 39 |
| 2019 January | 12 | 12 | 24 |
| 2018 December | 7 | 15 | 22 |
| 2018 November | 21 | 10 | 31 |
| 2018 October | 26 | 22 | 48 |
| 2018 September | 12 | 19 | 31 |
| 2018 May | 14 | 0 | 14 |
| 2018 April | 5 | 13 | 18 |
| 2018 March | 3 | 3 | 6 |
| 2018 February | 5 | 14 | 19 |
| 2018 January | 3 | 9 | 12 |
| 2017 December | 8 | 5 | 13 |
| 2017 November | 5 | 10 | 15 |
| 2017 October | 4 | 9 | 13 |
| 2017 September | 3 | 5 | 8 |
| 2017 August | 8 | 19 | 27 |
| 2017 July | 2 | 10 | 12 |
| 2017 June | 8 | 10 | 18 |
| 2017 May | 6 | 11 | 17 |
| 2017 April | 1 | 9 | 10 |
| 2017 March | 3 | 7 | 10 |
| 2017 February | 1 | 7 | 8 |
| 2017 January | 2 | 4 | 6 |
| 2016 December | 6 | 13 | 19 |
| 2016 November | 10 | 11 | 21 |
| 2016 October | 6 | 12 | 18 |
| 2016 September | 7 | 8 | 15 |
| 2016 August | 8 | 5 | 13 |
| 2016 July | 9 | 6 | 15 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 51 | 1 | 52 |
| 2015 September | 42 | 12 | 54 |
| 2015 August | 54 | 8 | 62 |
| 2015 July | 59 | 5 | 64 |
| 2015 June | 43 | 8 | 51 |
| 2015 May | 47 | 6 | 53 |
| 2015 April | 36 | 12 | 48 |
| 2015 March | 36 | 10 | 46 |
| 2015 February | 35 | 8 | 43 |
| 2015 January | 39 | 5 | 44 |
| 2014 December | 51 | 6 | 57 |
| 2014 November | 48 | 5 | 53 |
| 2014 October | 42 | 12 | 54 |
| 2014 September | 36 | 12 | 48 |
| 2014 August | 31 | 11 | 42 |
| 2014 July | 43 | 9 | 52 |
| 2014 June | 50 | 11 | 61 |
| 2014 May | 51 | 16 | 67 |
| 2014 April | 60 | 4 | 64 |
| 2014 March | 55 | 5 | 60 |
| 2014 February | 46 | 8 | 54 |
| 2014 January | 40 | 9 | 49 |
| 2013 December | 41 | 7 | 48 |
| 2013 November | 40 | 6 | 46 |
| 2013 October | 45 | 9 | 54 |
| 2013 September | 49 | 10 | 59 |
| 2013 August | 54 | 9 | 63 |
| 2013 July | 54 | 10 | 64 |
| 2013 June | 38 | 6 | 44 |
| 2013 May | 45 | 2 | 47 |
| 2013 April | 32 | 5 | 37 |
| 2013 March | 9 | 2 | 11 |
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