Vascular leak syndrome associated with interleukin-2: chest radiographic manifestations.
Adoptive immunotherapy with interleukin-2 (IL-2) is associated with a generalized vascular leak syndrome. Pulmonary edema is a common occurrence and is rarely responsible for acute respiratory failure requiring assisted ventilation. The authors have performed a retrospective review of chest radiographs in 19 patients undergoing the priming course of high-dose IL-2 therapy for metastatic melanoma and renal cell carcinoma. This study was primarily designed to evaluate the prevalence and patterns of pulmonary edema and pleural effusions. During the first 5 days of therapy, alveolar edema was identified in 21% (n = 4) and signs of interstitial edema in 53% (n = 10) of patients. Pleural effusions were seen in 42% (n = 8). No patient in this series required assisted ventilation during this period. However, two patients subsequently developed fatal, drug-related myocardial injury. IL-2 toxicity is a well established cause of self-limited, increased-permeability pulmonary edema.
Mann
H
H
Department of Radiology, University of Utah School of Medicine, Salt Lake City.
Ward
J H
JH
Samlowski
W E
WE
D002199:Capillary Permeability; D002292:Carcinoma, Renal Cell / Q000628:therapy; D002496:Central Venous Pressure; D006801:Humans; D007376:Interleukin-2 / Q000009:adverse effects* / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000628:therapy; D008168:Lung / Q000000981:diagnostic imaging; D008545:Melanoma / Q000556:secondary / Q000628:therapy; D010996:Pleural Effusion / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D011654:Pulmonary Edema / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D011859:Radiography; D012189:Retrospective Studies
D007376:Interleukin-2