Acute respiratory failure after interferon-gamma therapy of end-stage pulmonary fibrosis.
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.
Honoré
Isabelle
I
Service de Pneumologie, and Unité INSERM 408, Hôpital Bichat, 46 rue Henri Huchard, 75877 Paris Cedex 18, France.
Nunes
Hilario
H
Groussard
Odile
O
Kambouchner
Marianne
M
Chambellan
Arnaud
A
Aubier
Michel
M
Valeyre
Dominique
D
Crestani
Bruno
B
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
D005938:Glucocorticoids; D007371:Interferon-gamma