[Interstitial pneumonia during treatment with thalidomide in a patient with multiple myeloma].
A 66-year-old man was referred to our hospital for the treatment of refractory multiple myeloma with thalidomide. He had a history of an interstitial pneumonia of unknown etiology two months before admission. Eight days after starting 200 mg/ day of thalidomide, he developed dyspnea and fever, followed by a macropapular rash in the trunk. The dyspnea got worse and a CT scan revealed interstitial pneumonia 16 days after the treatment. He required mechanical ventilatory support. Bronchoalveolar lavage fluid revealed eosinophilia, suggesting a thalidomide-induced interstitial pneumonia. Thalidomide was discontinued and methylprednisolone (1000 mg/d x 3 days) was started, and the pneumonia and rash markedly improved within six days. After that the patient contracted MRSA pneumonia and died of MRSA septicemia.
Iguchi
Toyotaka
T
Division of Hematology, Department of Internal Medicine, Keio University School of Medicine.
Sakoda
Mariyo
M
Chen
Chien-kang
CK
Yokoyama
Kenji
K
Hattori
Yutaka
Y
Ikeda
Yasuo
Y
Okamoto
Shinichiro
S
D000368:Aged; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced*; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy*; D013792:Thalidomide / Q000009:adverse effects*
D013792:Thalidomide