DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20160132

Disulfiram induced hemoptysis: a case report

Ravishankar M., Rakshith N.

Abstract


Disulfiram (tetraethylthiuram disulfide [TETD]) has been used for more than 50 years as a deterrent to ethanol abuse in the management of alcoholism. Approximately 200,000 alcoholics take disulfiram, or Antabuse, regularly in the United States. Haemoptysis is the expectoration of blood originating from the lower respiratory tract. It is a common alarming symptom accounting for 10 to 15% of all pulmonary visits. Here, we present the case report of a 39-year old male patient who came to the medicine OPD with complaints of coughing of blood in the early morning hours since one and a half months. During history taking, it was understood that the patient was administered disulfiram by his wife, without his knowledge to prevent him from consuming alcohol since one and a half months (the patient is a chronic alcoholic). There was no history of any other drug intake which could cause haemoptysis like anticoagulants, thrombolytics and non-steroidal anti-inflammatory drugs. Infections causing haemoptysis like tuberculosis, pneumonia and bronchitis were ruled out. Haemoptysis subsided once disulfiram was stopped. Thus, in this case, because of the temporal relationship between exposure to the drug and the onset of symptoms, disulfiram was considered as the most probable cause of haemoptysis. The adverse drug reaction was considered probable (score 5) according to the Naranjo adverse drug reaction probability scale.


Keywords


Disulfiram, Antabuse, Hemoptysis, Alcoholism, Aldehyde syndrome, Tuberculosis, Pneumonia, Bronchitis, Naranjo adverse drug reaction probability scale

Full Text:

PDF

References


Baker JR, Jatlow P, McCance-Katz EF. Disulfiram effects on responses to intravenous cocaine administration. Drug Alcohol Depend. 2007;87(2-3):202-9.

Kong D, Kotraiah V. Modulation of aldehyde dehydrogenase activity affects (±)-4-hydroxy-2E-nonenal (HNE) toxicity and HNE-protein adduct levels in PC12 cell. J Mol Neurosci. 2012;47(3):595-603.

O’Neil KM, Lazarus AA. Hemoptysis. Indications for bronchoscopy. Arch Intern Med. 1991;151:171-4.

Pursel SE, Lindskog GE. Hemoptysis. A clinical evaluation of 105 patients examined consecutively on a thoracic surgical service. Am Rev Respir Dis. 1961;84:329-36.

Smiddy JF, Elliott RC. The evaluation of hemoptysis with fibreoptic bronchoscopy. Chest. 1973;64:158-62.

Stedman TL. Stedman’s medical dictionary. 27th edition. Philadelphia: Lipincott Williams & Wilkins; 2000.

Harrison TR, Braunwald E. Hemoptysis. In: Harrison’s Principles of Internal Medicine. 15th edition. New York: McGraw-Hill; 2001:203-6.

Valgini F, Viaggi C, Piro V, Pardini C, Gearace C, Scarselli M, Corsini GU. Acetaldehyde and parkinsonism: role of CYP450 2E1. Front Behav Neurosci. 2013;7:71.

Naranjo CA et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239-45.