9 Since the patient did not exhibit signs or symptoms of immunodeficiency before CBZ administration, and the hypogammaglobulinemia with absent B cells resolved after CBZ suspension, it is likely that CBZ therapy was responsible for this serious defect in humoral immune response. Confirmation of the

diagnosis with a further challenge with CBZ was not thought to be justified. CBZ-induced interstitial pneumonitis is a rare but well-described complication5 in adults. The mechanism of lung injury is believed to be an immune-mediated hypersensitivity response.10 In the present case, the thoracic CT findings and the clinical improvement after CBZ withdrawal, suggest a CBZ-induced interstitial find more pneumonitis. Despite the gradual improvement after the drug withdrawal, our patient still has some exercise intolerance, probably related to the marked decrease in lung volumes. Various patterns of lung disease months to years after an initial CBZ exposure have been reported before, mainly bronchiolitis obliterans organizing pneumonia and drug induced lupus.5, 6 and 11 Further clinical Navitoclax solubility dmso follow-up along with thoracic CT imaging will reveal any residual lung damage. CBZ continues to be a first-line drug for the treatment of epilepsy in children. The present report calls attention to the need for clinical

follow-up of CBZ-treated children, due to its various side effects, particularly affecting the immune system. We suggest that

immunoglobulins should be carefully examined in these children, particularly after CBZ initiation. Moreover, concomitant CBZ therapy should always be considered as a cause of interstitial pneumonitis, since CBZ withdrawal is the only effective treatment for further reducing lung injury. The authors report no biomedical financial interests or other potential conflicts of interest in this manuscript. There were no sponsors in this study. Daniel Gonçalves – conception and design of the manuscript, drafting of the article. Rute Moura – conception of the manuscript, data collection. Catarina Ferraz – Amine dehydrogenase manuscript revision. Bonito Vitor – manuscript revision. Luisa Vaz – final approval of the version to be published. “
“Petroleum diesel is a complex mixture of saturated and aromatic hydrocarbons produced from fractional distillation of crude oil with chemical additives like detergents, smoke suppressants, flow improvers etc. Aspiration of diesel may occur either directly or through aspiration of vomitus secondary to its ingestion.1 Hydrocarbon pneumonitis is an acute intense pneumonitis and most patients recover without any significant pulmonary sequelae.2 So far, very few studies on hydrocarbon pneumonitis due to diesel fuel aspiration have been reported in literature.3 and 4 We report a rare case of pneumonitis following diesel fuel aspiration.