Gefitinib-induced lung injury successfully treated with high-dose corticosteroids.
A 55-year-old man was treated with gefitinib for disseminated pleural lesions, 1 year after resection of the left lower lobe for non-small cell lung cancer. After 6 weeks of continuous daily treatment with oral gefitinib, he developed dyspnoea on exertion and a non-productive cough. CXR and CT revealed focal areas of ground-glass opacity (GGO) in the right upper lobe. Despite gefitinib being discontinued, high-resolution CT revealed extension of GGO and restructuring of lung parenchyma, suggesting acute interstitial pneumonia. Transbronchial biopsy revealed acute-phase diffuse alveolar damage. After administration of methylprednisolone pulse therapy (1 g/day intravenously) for three consecutive days, the areas of GGO shrank on high-resolution CT and symptoms resolved. Diffuse alveolar damage caused by gefitinib can be successfully treated in the early phase with high-dose corticosteroids. Patients receiving gefitinib should be carefully examined for symptoms and undergo CT if their condition deteriorates.
Seto
Takashi
T
Division of Pulmonary Medicine, Tokai University School of Medicine, Kanagawa, Japan. seto-t@is.icc.u-tokai.ac.jp
Seki
Nobuhiko
N
Uematsu
Kazutsugu
K
Tanigaki
Toshimori
T
Shioya
Sumie
S
Koboyashi
Toshiki
T
Umemura
Shinobu
S
Eguchi
Kenji
K
D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy; D000077156:Gefitinib; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000188:drug therapy* / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D010784:Photomicrography; D011799:Quinazolines / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib; D008775:Methylprednisolone