Severe eosinophilic pneumonia presenting during gemcitabine adjuvant chemotherapy.
Severe eosinophilic pneumonia presenting during gemcitabine adjuvant chemotherapy.
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DOI：
10.1186/1477-7819-11-167
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发表时间：
2013-07-24
影响因子：
3.2
通讯作者：
Noshiro H
中科院分区：
文献类型：
--
作者：
Yakabe T;Kitahara K;Komiya K;Sueoka-Aragane N;Kimura S;Sugioka T;Noshiro H
吉西他滨被广泛接受为胰腺癌的标准治疗，但它可能会导致不可预测的副作用。急性呼吸窘迫综合征是吉西他滨的一种罕见并发症，但有时是致命的。我们描述了一个治愈的情况下，急性，严重的吉西他滨引起的肺毒性。患者为一名76岁男性胰腺癌患者，术后接受吉西他滨辅助化疗。患者在第1、8和15天接受吉西他滨1，000 mg/m2治疗，持续3个4周周期，间隔1周。他在第三个周期的第1天出现了严重的全身疲劳。计算机断层扫描显示弥漫性磨玻璃样阴影伴胸腔积液。β-D-葡聚糖未增加，巨细胞病毒抗原血症检测呈阴性。未发现细菌和抗酸杆菌，支气管肺泡灌洗液中嗜酸性粒细胞增多。考虑到这些数据，我们诊断为吉西他滨诱导的嗜酸性粒细胞性肺炎。患者立即接受类固醇和中性粒细胞弹性蛋白酶抑制剂治疗，并接受呼吸支持治疗。4周后，他的肺部症状明显改善。医生应认识到严重肺毒性与吉西他滨治疗的可能相关性。诊断和治疗的延误可能导致致命的后果。
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.
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影响因子：
19.7
作者：
Johkoh, T;Müller, NL;Nakamura, H
通讯作者：
Nakamura, H
影响因子：
3
作者：
Ferreira Galvao, Flavio Henrique;Medina Pestana, Jose Osmar;Capelozzi, Vera Luiza
通讯作者：
Capelozzi, Vera Luiza
影响因子：
8.8
作者：
通讯作者：
--
影响因子：
2.9
作者：
Barlési, F;Villani, P;Kleisbauer, JP
通讯作者：
Kleisbauer, JP
DOI：
10.1097/00000421-200202000-00021
发表时间：
2002-02-01
影响因子：
2.6
作者：
Gupta, N;Ahmed, I;Mehrotra, B
通讯作者：
Mehrotra, B