title: Acute respiratory failure after interferon-gamma therapy of end-stage pulmonary fibrosis.
abstract: Interferon (IFN)-gamma was recently proposed as a treatment for idiopathic pulmonary fibrosis. We report on four patients who developed acute respiratory failure with new alveolar opacities after 2 (two patients), 6, and 35 injections of IFN-gamma-1b. All four patients had advanced idiopathic pulmonary fibrosis (total lung capacity less than 45% predicted or carbon monoxide diffusion capacity less than 30% predicted), and two patients had familial pulmonary fibrosis. No other cause of deterioration was found. Refractory hypoxemia led to death in three cases and to lung transplantation in one case. Pathologic studies in two patients showed diffuse alveolar damage lesions with preexisting usual interstitial pneumonia. These cases suggest that IFN-gamma therapy can induce an acute respiratory failure in patients with end-stage idiopathic pulmonary fibrosis.
authors.affiliation: Service de Pneumologie, and Unité INSERM 408, Hôpital Bichat, 46 rue Henri Huchard, 75877 Paris Cedex 18, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Honoré
authors.forename: Hilario
authors.initials: H
authors.lastname: Nunes
authors.forename: Odile
authors.initials: O
authors.lastname: Groussard
authors.forename: Marianne
authors.initials: M
authors.lastname: Kambouchner
authors.forename: Arnaud
authors.initials: A
authors.lastname: Chambellan
authors.forename: Michel
authors.initials: M
authors.lastname: Aubier
authors.forename: Dominique
authors.initials: D
authors.lastname: Valeyre
authors.forename: Bruno
authors.initials: B
authors.lastname: Crestani
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007371:Interferon-gamma / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000150:complications / Q000188:drug therapy; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D017211:Treatment Failure
chemical_list: D005938:Glucocorticoids; D007371:Interferon-gamma