Pulmonary capillary hemangiomatosis with atypical endotheliomatosis: successful antiangiogenic therapy with doxycycline.
We report here our experience in achieving remission in a 20-year-old man with pulmonary capillary hemangiomatosis (PCH) with atypical endotheliomatosis following therapy with doxycycline. PCH is a rare disorder characterized by proliferating capillaries that invade the pulmonary interstitium and alveolar septae, and occlude the pulmonary vasculature. The patient's symptoms, lung function, and radiographic findings had worsened despite treatment with both prednisone and alpha-interferon. He was considered to be a candidate for transplantation. Given the elevated levels of basic fibroblast growth factor (bFGF) in urine and the capillary proliferation noted on biopsy specimens, we elected to treat the patient with doxycycline, a matrix metalloproteinase and angiogenesis inhibitor. Following several weeks of therapy, a gradual resolution of symptoms was noted, with normalization of pulmonary function test results and urine bFGF levels. After 18 months of therapy, the patient remains in complete remission.
Ginns
Leo C
LC
Pulmonary and Critical Care Unit, General Medical Services, Massachusetts General Hospital, Boston, MA 02114, USA. lginns@partners.org
Roberts
David H
DH
Mark
Eugene J
EJ
Brusch
John L
JL
Marler
Jennifer J
JJ
D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use*; D004727:Endothelium / Q000473:pathology; D016222:Fibroblast Growth Factor 2 / Q000652:urine; D018324:Hemangioma, Capillary / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D061965:Matrix Metalloproteinase Inhibitors
D020533:Angiogenesis Inhibitors; D061965:Matrix Metalloproteinase Inhibitors; D016222:Fibroblast Growth Factor 2; D004318:Doxycycline