Anti-Helicobacter pylori Infection Treatment and Pulmonary Hypersensitivity: Case Series and Review of the Literature

Abstract

Background: Helicobacter pylori (H. pylori) infection is currently widespread throughout the world. Bismuth-containing quadruple therapy is widely used, but it has rarely been associated with interstitial lung disease.

Case presentation: We described six cases with similar clinical symptoms and typical pulmonary interstitial imaging changes during anti-H. pylori therapy, usually on Days 7-12 following treatment. Anti-H. pylori infection treatment was discontinued when it was suspected to be the cause of the clinical symptoms, and all of the patients accepted observation therapy. All of them had a favorable outcome, the clinical symptoms returned to normal almost 1 week later, and the chest computed tomography (CT) scan images showed remarkable absorption 4 weeks later.

Conclusions: Drug interactions could be the cause, and the most likely drug was furazolidone. All of the patients recovered quickly after drug discontinuation, and low-dose steroid may help shorten the recovery time.

Keywords: anti‐H. pylori infection treatment; bismuth‐containing quadruple therapy; furazolidone; interstitial lung disease; pulmonary hypersensitivity.

FIGURE 1

(A) Bilateral interstitial infiltrates in the lower lobe of Case 1; (B) bilateral interstitial infiltrates in the lower lobe of Case 2; (C) bilateral infiltration in the lower lobe of Case 3; (D) bilateral little infiltration in the lower lobe of Case 4; (E) bilateral infiltration in the lower lobe of Case 5; (F) bilateral interstitial infiltration and little pleural effusion of Case 6.