Paclitaxel-induced cell-mediated hypersensitivity pneumonitis. Diagnosis using leukocyte migration test, bronchoalveolar lavage and transbronchial lung biopsy.
A 73-year-old man with mild inactive interstitial pneumonitis and non-small cell bronchogenic carcinoma developed a cell-mediated hypersensitivity pneumonitis within 15 days following a second exposure to paclitaxel. Histological features of transbronchial lung biopsy were consistent with interstitial pneumonitis. Bronchoalveolar lavage showed increased lymphocytes and eosinophils, and decreased helper/suppressor T lymphocyte ratio. Leukocyte migration inhibitory test was positive for paclitaxel. These results support the possibility that paclitaxel-induced pneumonitis is due to delayed type hypersensitivity; they also support the hypothesis of a central role of T lymphocytes in drug-induced pneumonitis.
Fujimori
K
K
Department of Internal Medicine, Niigata Cancer Center Hospital, Japan. k-fuji@ta2.so-net.or.jp
Yokoyama
A
A
Kurita
Y
Y
Uno
K
K
Saijo
N
N
D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D001706:Biopsy / Q000379:methods; D001980:Bronchi; D018893:Bronchoalveolar Lavage; D002464:Cell Migration Inhibition; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007962:Leukocytes / Q000187:drug effects*; D008168:Lung / Q000276:immunology / Q000473:pathology; D008297:Male; D017239:Paclitaxel / Q000009:adverse effects*; D011014:Pneumonia / Q000139:chemically induced* / Q000276:immunology* / Q000473:pathology
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel