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Vol. 42. Issue 1.
Pages 42-44 (January 2006)
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Vol. 42. Issue 1.
Pages 42-44 (January 2006)
Case Reports
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Strong Suspicion of Lung Toxicity Due to Riluzole
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L. Borderías-Claua,
Corresponding author
lborderias@separ.es

Correspondence: Dr. L. Borderías-Clau. Sección de Neumología. Hospital San Jorge. Avda. Martínez de Velasco, 36. 22004 Huesca. España
, J. Garrapiz-Lópeza, P. Val-Adána, C. Tordesillas-Líab, A. Alcacera-Lópezc, J.L. Bru-Martína
a Sección de Neumología, Hospital General San Jorge, Huesca, Spain
b Sección de Neurología, Hospital General San Jorge, Huesca, Spain
c Farmacia, Hospital General San Jorge, Huesca, Spain
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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.

Key words:
Riluzole
Lung toxicity
Amyotrophic lateral sclerosis
Pulmonary infiltrates

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.

Palabras clave:
Riluzol
Toxicidad pulmonar
Esclerosis lateral amiotrófica (ELA)
Infiltrados pulmonares
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Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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