Severe eosinophilic pneumonia presenting during gemcitabine adjuvant chemotherapy

World Journal of Surgical Oncology

Hirokazu Noshiro³  Takashi Sugioka²  Shinya Kimura¹  Naoko Sueoka-Aragane¹  Kazutoshi Komiya¹  Kenji Kitahara³  Tomomi Yakabe³ 

[1] Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan;Department of Community Medical Support Institute, Saga University, Saga, Japan;Department of Surgery, Saga University Faculty of Medicine, Saga, Japan

关键词: Pulmonary toxicity;    Adverse event;    Acute lung injury;    Eosinophilic pneumonia;    Adjuvant chemotherapy;    Gemcitabine;    Pancreatic cancer;   

Others  :  823660
DOI  :  10.1186/1477-7819-11-167

 received in 2012-05-05, accepted in 2013-07-07,  发布年份 2013

【 摘 要 】

Gemcitabine is widely accepted as the standard treatment for pancreatic cancer, but it can cause unpredictable side effects. Acute respiratory distress syndrome is a rare complication with gemcitabine, but is sometimes fatal. We describe a cured case of acute, severe gemcitabine-induced pulmonary toxicity. The patient was a 76-year-old man with pancreatic cancer who was receiving adjuvant gemcitabine chemotherapy after surgery. The patient received gemcitabine 1,000 mg/m² on days 1, 8, and 15 for three 4-week cycles, with intervals of 1 week. He developed severe general fatigue on day 1 of the third cycle. Computed tomography showed diffuse ground-glass opacity with pleural effusion. There was no increase in β-D-glucan, and cytomegalovirus antigenemia assays were negative. No bacteria or acid-fast bacilli were found. The number of eosinophils in bronchoalveolar lavage fluid was increased. Considering these data, we diagnosed eosinophilic pneumonia induced by gemcitabine. The patient was immediately treated with a steroid and neutrophil elastase inhibitor under respiratory supportive therapy. After 4 weeks, his pulmonary symptoms were markedly improved. Physicians should be cognizant of the possible association of serious pulmonary toxicity with gemcitabine treatment. A delay in diagnosis and treatment could lead to a fatal outcome.

【 授权许可】

   
2013 Yakabe et al.; licensee BioMed Central Ltd.

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