Disulfiram induced hemoptysis: a case report

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.