Hypersensitivity pneumonitis associated with co-proxamol (paracetamol plusdextropropoxyphene) therapy

A 61-year-old man developed hypersensitivity pneumonitis and skin rash in c lose association with taking co-proxamol. These problems occurred in spite of being treated with prednisolone 40 mg daily (20 mg daily at the time of presentation) for assumed cranial arteritis. A therapeutic challenge with p aracetamol was negative and the patient continues to take this drug. It see ms likely that this patient's rash and hypersensitivity pneumonitis was cau sed by dextropropoxyphene. Dextropropoxyphene has not been reported previou sly as a cause of hypersensitivity pneumonitis.