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CRITICAL CARE AND TRAUMA

Rapid Development of Severe Interstitial Pneumonia Caused by Epoprostenol in a Patient with Primary Pulmonary Hypertension

Hiroshi Morimatsu, MD^*, Keiji Goto, MD^*, Takashi Matsusaki, MD^*, Hiroshi Katayama, MD PhD^*, Hiromi Matsubara, MD PhD, Tohru Ohe, MD PhD, and Kiyoshi Morita, MD PhD

Departments of *Anesthesiology and Intensive Care and Cardiology, Okayama University Medical School, Okayama, Japan

Address correspondence and reprint requests to Hiroshi Morimatsu, MD, Department of Anesthesiology and Intensive Care, Okayama University Medical School, 2-5-1, Shikata-cho, Okayama 700-8558, Japan. Address e-mail to morimatu{at}pop21.odn.ne.jp

A young woman with primary pulmonary hypertension developed severe interstitial pneumonia (IP) 5 days after induction of epoprostenol infusion. Although the pathogen involved was not identified, her IP was initially responsive to steroids, and discontinuation of steroid therapy caused the redevelopment of IP. After intensive treatment, including steroid therapy and inhaled nitric oxide, epoprostenol was successfully switched to prostaglandin E₁ infusion and she recovered. Epoprostenol infusion can cause a rapid severe IP, even soon after the induction of therapy. Clinicians should keep this syndrome in mind, especially when treating a severe case of IP.

IMPLICATIONS: Epoprostenol infusion can cause a rapid, severe interstitial pneumonia (IP), even soon after the induction of therapy. Clinicians should keep this syndrome in mind, especially when treating a severe case of IP.