[Hydroxyurea-induced pneumonitis].
BACKGROUND
Hydroxyurea (HU) is a good-controllable and well-tolerated cytostatic drug.


METHODS
Two patients with a myeloproliferative disease, who suffered from fever, lung symptoms and reticulonodular infiltrates on both sides after 4 and 10 weeks of HU medication, are introduced. One patient additionally presented with multiple, 1-cm diameter, pustulous (central abscess-like), elevated, livid skin lesions on his forearms and shins. After discontinuance of the HU administration, symptoms vanished within 1-2 days, but could be reinduced by HU reexposition within hours.


CONCLUSIONS
Nine cases with a pneumonitis (alveolitis or interstitial lung disease) have been described so far. In all cases, including ours, HU medication was usually administered over a 3- to 12-week period, mostly for 4 weeks (five of eleven cases). All patients showed a uniform illness with fever (11/11), chills (6/11), reticular or nodular infiltrates on both sides (11/11), small pleural effusions (5/11), and lung symptoms (11/11) such as dyspnea (10/11) or cough (5/11). Due to the acute or subacute onset, all cases were first misinterpreted as bacterial pneumonia.
Schwonzen
Martin
M
Innere Medizin II, St. Walburga-Krankenhaus, Meschede. Schwonzen@freenet.de
Spangenberger
Holger
H
Spengler
Michael
M
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000139:chemically induced* / Q000175:diagnosis; D011087:Polycythemia Vera / Q000188:drug therapy*; D055728:Primary Myelofibrosis / Q000188:drug therapy*; D013922:Thrombocytosis / Q000188:drug therapy*
D000970:Antineoplastic Agents; D006918:Hydroxyurea