Skip to main content
Top
Published in:

Open Access 17-06-2024 | Interventional Procedure in Cardiology | Case Report

Coronary stent implantation links to the occurrence of eosinophilia and interstitial pneumonia: a case report and systematic review

Authors: Fuyun Zhang, Wei Wang, Yingwei Zhu, Yimin Mao, Tongsheng Wang, Pengfei Gao

Published in: BMC Pulmonary Medicine | Issue 1/2024

Login to get access

Abstract

Background

Rapamycin has been extensively utilized for coating coronary artery stents to reduce the occurrence of restenosis, yet there has been limited research on the potential harms of rapamycin-eluting stents. Herein, We report a case of eosinophilia and interstitial pneumonia caused by a cobalt-based alloy stent eluted with rapamycin.

Case presentation

The patient was admitted due to fever, cough, and expectoration symptoms. Previously, the patient had undergone a procedure of percutaneous coronary stent implantation in our hospital’s cardiology department, which led to a gradual rise in blood eosinophil count. This time, the eosinophil count was higher than the previous admission. A chest CT scan revealed multiple flocculent density increases in both lungs and bronchiectasis. The rapamycin-eluting stents may have caused eosinophilia and interstitial pneumonia, which improved after administering corticosteroids. A systematic review of relevant literature was conducted to summarize the characteristics of interstitial pneumonia caused by drug-eluting stents.

Conclusion

Paclitaxel, everolimus, zotarolimus, and rapamycin are the types of drugs that can lead to drug-eluting stents, and because of the rarity of their onset, clinical doctors must be precise and prompt in diagnosing suspected cases to avoid misdiagnosis and delayed treatment.
Literature
1.
go back to reference Katz G, Harchandani B, Shah B. Drug-eluting stents: the past, present, and future. Curr Atheroscler Rep. 2015;17(3):485.CrossRefPubMed Katz G, Harchandani B, Shah B. Drug-eluting stents: the past, present, and future. Curr Atheroscler Rep. 2015;17(3):485.CrossRefPubMed
2.
go back to reference Kato K, Fukuda S, Fujimaki T, Takano Y, Kunii E, Kato K, Watanabe K, Suzuki S, Yamada K, Yokoi K, et al. Paclitaxel-induced interstitial pneumonia after drug-eluting stent implantation: report of a fatal case. Intern Med. 2009;48(11):911–3.CrossRefPubMed Kato K, Fukuda S, Fujimaki T, Takano Y, Kunii E, Kato K, Watanabe K, Suzuki S, Yamada K, Yokoi K, et al. Paclitaxel-induced interstitial pneumonia after drug-eluting stent implantation: report of a fatal case. Intern Med. 2009;48(11):911–3.CrossRefPubMed
3.
go back to reference Fujimaki T, Kato K, Fukuda S, Watanabe K, Mori T, Hibino T. Acute interstitial pneumonitis after implantation of paclitaxel-eluting stents: a report of two fatal cases. Int J Cardiol. 2011;148(2):e21–24.CrossRefPubMed Fujimaki T, Kato K, Fukuda S, Watanabe K, Mori T, Hibino T. Acute interstitial pneumonitis after implantation of paclitaxel-eluting stents: a report of two fatal cases. Int J Cardiol. 2011;148(2):e21–24.CrossRefPubMed
4.
go back to reference Chiba T, Ishizuka T, Ogata T, Tadaki S, Fujita H, Yamaguchi N, Onoue N, Tanaka M, Shinozaki T, Kikuchi Y. [Case report: a case of drug-induced interstitial pneumonitis by everolimus-eluting coronary stent]. Nihon Naika Gakkai Zasshi. 2012;101(12):3522–4.CrossRefPubMed Chiba T, Ishizuka T, Ogata T, Tadaki S, Fujita H, Yamaguchi N, Onoue N, Tanaka M, Shinozaki T, Kikuchi Y. [Case report: a case of drug-induced interstitial pneumonitis by everolimus-eluting coronary stent]. Nihon Naika Gakkai Zasshi. 2012;101(12):3522–4.CrossRefPubMed
5.
go back to reference Sakamoto S, Kikuchi N, Ichikawa A, Sano G, Satoh K, Sugino K, Isobe K, Takai Y, Shibuya K, Homma S. Everolimus-induced pneumonitis after drug-eluting stent implantation: a case report. Cardiovasc Intervent Radiol. 2013;36(4):1151–4.CrossRefPubMed Sakamoto S, Kikuchi N, Ichikawa A, Sano G, Satoh K, Sugino K, Isobe K, Takai Y, Shibuya K, Homma S. Everolimus-induced pneumonitis after drug-eluting stent implantation: a case report. Cardiovasc Intervent Radiol. 2013;36(4):1151–4.CrossRefPubMed
6.
go back to reference Shin HW, Nam CW, Kim H, Hur SH, Kim YN, Kim KB, Kwon KY. Zotarolimus-eluting stent-induced hypersensitivity pneumonitis. Korean J Intern Med. 2013;28(1):108–11.CrossRefPubMed Shin HW, Nam CW, Kim H, Hur SH, Kim YN, Kim KB, Kwon KY. Zotarolimus-eluting stent-induced hypersensitivity pneumonitis. Korean J Intern Med. 2013;28(1):108–11.CrossRefPubMed
7.
go back to reference Liu J, Liu Z, Gao Y, Zhao P. Sirolimus-eluting sents related interstitial pneumonia. J Adverse Drug React. 2018;20(5):378–9. Liu J, Liu Z, Gao Y, Zhao P. Sirolimus-eluting sents related interstitial pneumonia. J Adverse Drug React. 2018;20(5):378–9.
8.
go back to reference Kobayashi H. Everolimus-Eluting stent-induced Pneumonitis. Am J Respir Crit Care Med. 2022;205(6):12–3.CrossRefPubMed Kobayashi H. Everolimus-Eluting stent-induced Pneumonitis. Am J Respir Crit Care Med. 2022;205(6):12–3.CrossRefPubMed
9.
go back to reference Nebeker JR, Virmani R, Bennett CL, Hoffman JM, Samore MH, Alvarez J, Davidson CJ, McKoy JM, Raisch DW, Whisenant BK, et al. Hypersensitivity cases associated with drug-eluting coronary stents: a review of available cases from the research on adverse drug events and reports (RADAR) project. J Am Coll Cardiol. 2006;47(1):175–81.CrossRefPubMed Nebeker JR, Virmani R, Bennett CL, Hoffman JM, Samore MH, Alvarez J, Davidson CJ, McKoy JM, Raisch DW, Whisenant BK, et al. Hypersensitivity cases associated with drug-eluting coronary stents: a review of available cases from the research on adverse drug events and reports (RADAR) project. J Am Coll Cardiol. 2006;47(1):175–81.CrossRefPubMed
10.
go back to reference Oishi Y, Sando Y, Tajima S, Maeno T, Maeno Y, Sato M, Hosono T, Suga T, Kurabayashi M, Nagai R. Indomethacin induced bulky lymphadenopathy and eosinophilic pneumonia. Respirology. 2001;6(1):57–60.CrossRefPubMed Oishi Y, Sando Y, Tajima S, Maeno T, Maeno Y, Sato M, Hosono T, Suga T, Kurabayashi M, Nagai R. Indomethacin induced bulky lymphadenopathy and eosinophilic pneumonia. Respirology. 2001;6(1):57–60.CrossRefPubMed
11.
go back to reference Nemery B, Verbeken EK, Demedts M. Giant cell interstitial pneumonia (hard metal lung disease, cobalt lung). Semin Respir Crit Care Med. 2001;22(4):435–48.CrossRefPubMed Nemery B, Verbeken EK, Demedts M. Giant cell interstitial pneumonia (hard metal lung disease, cobalt lung). Semin Respir Crit Care Med. 2001;22(4):435–48.CrossRefPubMed
12.
go back to reference Adams TN, Butt YM, Batra K, Glazer CS. Cobalt related interstitial lung disease. Respir Med. 2017;129:91–7.CrossRefPubMed Adams TN, Butt YM, Batra K, Glazer CS. Cobalt related interstitial lung disease. Respir Med. 2017;129:91–7.CrossRefPubMed
13.
go back to reference Fels Elliott DR, Shah R, Hess CA, Elicker B, Henry TS, Rule AM, Chen R, Golozar M, Jones KD. Giant cell interstitial pneumonia secondary to cobalt exposure from e-cigarette use. Eur Respir J 2019, 54(6). Fels Elliott DR, Shah R, Hess CA, Elicker B, Henry TS, Rule AM, Chen R, Golozar M, Jones KD. Giant cell interstitial pneumonia secondary to cobalt exposure from e-cigarette use. Eur Respir J 2019, 54(6).
14.
go back to reference Wyles CC, Wright TC, Bois MC, Amin MS, Fayyaz A, Jenkins SM, Wyles SP, Day PL, Murray DL, Trousdale RT, et al. Myocardial cobalt levels are elevated in the setting of total hip arthroplasty. J Bone Joint Surg Am. 2017;99(22):e118.CrossRefPubMed Wyles CC, Wright TC, Bois MC, Amin MS, Fayyaz A, Jenkins SM, Wyles SP, Day PL, Murray DL, Trousdale RT, et al. Myocardial cobalt levels are elevated in the setting of total hip arthroplasty. J Bone Joint Surg Am. 2017;99(22):e118.CrossRefPubMed
15.
go back to reference Forni A. Bronchoalveolar lavage in the diagnosis of hard metal disease. Sci Total Environ. 1994;150(1–3):69–76.CrossRefPubMed Forni A. Bronchoalveolar lavage in the diagnosis of hard metal disease. Sci Total Environ. 1994;150(1–3):69–76.CrossRefPubMed
16.
go back to reference Chiarchiaro J, Tomsic LR, Strock S, Veraldi KL, Nouraie M, Sellares J, Lindell KO, Ortiz LA, Sciurba FC, Kucera RF, et al. A case series describing common radiographic and pathologic patterns of hard metal pneumoconiosis. Respir Med Case Rep. 2018;25:124–8.PubMedPubMedCentral Chiarchiaro J, Tomsic LR, Strock S, Veraldi KL, Nouraie M, Sellares J, Lindell KO, Ortiz LA, Sciurba FC, Kucera RF, et al. A case series describing common radiographic and pathologic patterns of hard metal pneumoconiosis. Respir Med Case Rep. 2018;25:124–8.PubMedPubMedCentral
17.
go back to reference Saini Y, Greenwood KK, Merrill C, Kim KY, Patial S, Parameswaran N, Harkema JR, LaPres JJ. Acute cobalt-induced lung injury and the role of hypoxia-inducible factor 1alpha in modulating inflammation. Toxicol Sci. 2010;116(2):673–81.CrossRefPubMedPubMedCentral Saini Y, Greenwood KK, Merrill C, Kim KY, Patial S, Parameswaran N, Harkema JR, LaPres JJ. Acute cobalt-induced lung injury and the role of hypoxia-inducible factor 1alpha in modulating inflammation. Toxicol Sci. 2010;116(2):673–81.CrossRefPubMedPubMedCentral
19.
go back to reference Ganesh SK, Subathra Devi C. Molecular and therapeutic insights of rapamycin: a multi-faceted drug from Streptomyces hygroscopicus. Mol Biol Rep. 2023;50(4):3815–33.CrossRefPubMedPubMedCentral Ganesh SK, Subathra Devi C. Molecular and therapeutic insights of rapamycin: a multi-faceted drug from Streptomyces hygroscopicus. Mol Biol Rep. 2023;50(4):3815–33.CrossRefPubMedPubMedCentral
20.
go back to reference Xu KF, Tian X, Yang Y, Zhang H. Rapamycin for lymphangioleiomyomatosis: optimal timing and optimal dosage. Thorax. 2018;73(4):308–10.CrossRefPubMed Xu KF, Tian X, Yang Y, Zhang H. Rapamycin for lymphangioleiomyomatosis: optimal timing and optimal dosage. Thorax. 2018;73(4):308–10.CrossRefPubMed
21.
go back to reference Lee HS, Huh KH, Kim YS, Kim MS, Kim HJ, Kim SI, Joo DJ. Sirolimus-induced pneumonitis after renal transplantation: a single-center experience. Transpl Proc. 2012;44(1):161–3.CrossRef Lee HS, Huh KH, Kim YS, Kim MS, Kim HJ, Kim SI, Joo DJ. Sirolimus-induced pneumonitis after renal transplantation: a single-center experience. Transpl Proc. 2012;44(1):161–3.CrossRef
22.
go back to reference Nguyen LS, Vautier M, Allenbach Y, Zahr N, Benveniste O, Funck-Brentano C, Salem JE. Sirolimus and mTOR inhibitors: a review of Side effects and Specific Management in Solid Organ Transplantation. Drug Saf. 2019;42(7):813–25.PubMed Nguyen LS, Vautier M, Allenbach Y, Zahr N, Benveniste O, Funck-Brentano C, Salem JE. Sirolimus and mTOR inhibitors: a review of Side effects and Specific Management in Solid Organ Transplantation. Drug Saf. 2019;42(7):813–25.PubMed
23.
go back to reference Morelon E, Stern M, Israel-Biet D, Correas JM, Danel C, Mamzer-Bruneel MF, Peraldi MN, Kreis H. Characteristics of sirolimus-associated interstitial pneumonitis in renal transplant patients. Transplantation. 2001;72(5):787–90.CrossRefPubMed Morelon E, Stern M, Israel-Biet D, Correas JM, Danel C, Mamzer-Bruneel MF, Peraldi MN, Kreis H. Characteristics of sirolimus-associated interstitial pneumonitis in renal transplant patients. Transplantation. 2001;72(5):787–90.CrossRefPubMed
24.
go back to reference Greveling K, Kunkeler AC, Prens EP, van Doorn MB. Allergic contact dermatitis caused by topical sirolimus used as an adjuvant for laser treatment of port wine stains. Contact Dermat. 2016;75(3):184–5.CrossRef Greveling K, Kunkeler AC, Prens EP, van Doorn MB. Allergic contact dermatitis caused by topical sirolimus used as an adjuvant for laser treatment of port wine stains. Contact Dermat. 2016;75(3):184–5.CrossRef
25.
go back to reference Howard L, Gopalan D, Griffiths M, Mahadeva R. Sirolimus-induced pulmonary hypersensitivity associated with a CD4 T-cell infiltrate. Chest. 2006;129(6):1718–21.CrossRefPubMed Howard L, Gopalan D, Griffiths M, Mahadeva R. Sirolimus-induced pulmonary hypersensitivity associated with a CD4 T-cell infiltrate. Chest. 2006;129(6):1718–21.CrossRefPubMed
26.
go back to reference Hua W, Liu H, Xia LX, Tian BP, Huang HQ, Chen ZY, Ju ZY, Li W, Chen ZH, Shen HH. Rapamycin inhibition of eosinophil differentiation attenuates allergic airway inflammation in mice. Respirology. 2015;20(7):1055–65.CrossRefPubMed Hua W, Liu H, Xia LX, Tian BP, Huang HQ, Chen ZY, Ju ZY, Li W, Chen ZH, Shen HH. Rapamycin inhibition of eosinophil differentiation attenuates allergic airway inflammation in mice. Respirology. 2015;20(7):1055–65.CrossRefPubMed
27.
go back to reference Fredriksson K, Fielhaber JA, Lam JK, Yao X, Meyer KS, Keeran KJ, Zywicke GJ, Qu X, Yu ZX, Moss J, et al. Paradoxical effects of rapamycin on experimental house dust mite-induced asthma. PLoS ONE. 2012;7(5):e33984.CrossRefPubMedPubMedCentral Fredriksson K, Fielhaber JA, Lam JK, Yao X, Meyer KS, Keeran KJ, Zywicke GJ, Qu X, Yu ZX, Moss J, et al. Paradoxical effects of rapamycin on experimental house dust mite-induced asthma. PLoS ONE. 2012;7(5):e33984.CrossRefPubMedPubMedCentral
28.
go back to reference Mushaben EM, Kramer EL, Brandt EB, Khurana Hershey GK, Le Cras TD. Rapamycin attenuates airway hyperreactivity, goblet cells, and IgE in experimental allergic asthma. J Immunol. 2011;187(11):5756–63.CrossRefPubMed Mushaben EM, Kramer EL, Brandt EB, Khurana Hershey GK, Le Cras TD. Rapamycin attenuates airway hyperreactivity, goblet cells, and IgE in experimental allergic asthma. J Immunol. 2011;187(11):5756–63.CrossRefPubMed
29.
go back to reference Gabbasov ZA, Kozlov SG, Lyakishev AA, Saburova OS, Smirnov VA, Smirnov VN. Polymorphonuclear blood leukocytes and restenosis after intracoronary implantation of drug-eluting stents. Can J Physiol Pharmacol. 2009;87(2):130–6.CrossRefPubMed Gabbasov ZA, Kozlov SG, Lyakishev AA, Saburova OS, Smirnov VA, Smirnov VN. Polymorphonuclear blood leukocytes and restenosis after intracoronary implantation of drug-eluting stents. Can J Physiol Pharmacol. 2009;87(2):130–6.CrossRefPubMed
30.
go back to reference Hajizadeh R, Ghaffari S, Separham A, Shokouhi B, Kavandi H, Pourafkari L, Nader ND. The value of peripheral blood eosinophil count in predicting in-stent restenosis in patients with stable angina pectoris undergoing drug eluting stenting. Romanian J Intern Med = Revue Roumaine de Med Interne. 2017;55(4):229–36.CrossRef Hajizadeh R, Ghaffari S, Separham A, Shokouhi B, Kavandi H, Pourafkari L, Nader ND. The value of peripheral blood eosinophil count in predicting in-stent restenosis in patients with stable angina pectoris undergoing drug eluting stenting. Romanian J Intern Med = Revue Roumaine de Med Interne. 2017;55(4):229–36.CrossRef
Metadata
Title
Coronary stent implantation links to the occurrence of eosinophilia and interstitial pneumonia: a case report and systematic review
Authors
Fuyun Zhang
Wei Wang
Yingwei Zhu
Yimin Mao
Tongsheng Wang
Pengfei Gao
Publication date
17-06-2024
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2024
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-024-03101-x

Other articles of this Issue 1/2024

BMC Pulmonary Medicine 1/2024 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Webinar | 06-02-2024 | 20:00 (CET)

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by: Viatris

Developed by: Springer Healthcare
Live Webinar | 01-10-2024 | 12:30 (CEST)

Recent advances in the use of CAR T-cell therapies in relapsed/refractory diffuse large B-cell lymphoma and follicular lymphoma

Live: Tuesday 1st October 2024, 12:30-14:00 (CEST)

In this live webinar, Professor Martin Dreyling and an esteemed, international panel of CAR-T experts will discuss the very latest data on the safety, efficacy and clinical impact of CAR T-cell therapies in the treatment of r/r DLBCL and r/r FL, as presented at ASH 2023, EU CAR-T 2024, and EHA 2024. 

Please note, this webinar is not intended for healthcare professionals based in the US and UK.

Sponsored by: Novartis Pharma AG

Chaired by: Prof. Martin Dreyling
Developed by: Springer Healthcare