title: [A case of drug-induced interstitial pneumonitis after adjuvant chemotherapy with gemcitabine for pancreatic cancer].
abstract: We present a case of interstitial pneumonitis induced by gemcitabine. The patient was a 48-year-old male who underwent pancreaticoduodenectomy with portal vein resection for ductal adenocarcinoma of the pancreas head. Twenty-two days after operation, adjuvant chemotherapy with gemcitabine(1,000 mg/m(2) on days 1, 8 and 15 every 4 weeks)was started. During three courses of chemotherapy, no adverse event of WHO grade 2 or more was observed. Seven days after the last infusion, fever and consciousness disorder emerged without respiratory symptoms. Arterial blood gas analysis revealed severe hypoxemia. Chest X-ray and CT showed diffuse bilateral interstitial infiltrates. Oxygenation and respiratory support were immediately given, and steroid pulse therapy with 1,000 mg/day of methylprednisolone was started. His symptoms and radiolographical findings were dramatically improved. The patient could be discharged on the 14th day after admission. Acute pulmonary toxicity induced by gemcitabine is rare, but could lead to severe complications. The review of reported cases showed the effectiveness of corticosteroid therapy for pulmonary toxicity due to the agent.
authors.affiliation: Dept. of Surgery, Tokyo Women's Medical University Medical Center East.
authors.forename: Dal
authors.initials: D
authors.lastname: Ho Kim
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuchiya
authors.forename: Takebumi
authors.initials: T
authors.lastname: Usui
authors.forename: Satoshi
authors.initials: S
authors.lastname: Inose
authors.forename: Masaki
authors.initials: M
authors.lastname: Aizawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshimatsu
authors.forename: Takao
authors.initials: T
authors.lastname: Katsube
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Naritaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D000093542:Gemcitabine