title: Interstitial pneumonitis induced by bicalutamide given for prostate cancer.
abstract: We describe interstitial pneumonitis induced by bicalutamide prescribed to treat prostate cancer. A 78-year-old man with severe lower paralysis and a bladder/rectal disorder was referred to our hospital. Prostate-specific antigen was elevated to 1418 ng/mL at that time and magnetic resonance imaging revealed multiple bone metastases. A rectal examination revealed hard nodules in the bilateral lobes of the prostate. We diagnosed prostate cancer without a biopsy, and then maximally blockaded androgens by castration and bicalutamide administration. Eight months later, he was admitted to a local hospital with breathing difficulties, and a computed tomography scan revealed interstitial pneumonitis. A physician concluded that the cause of the interstitial pneumonitis was bicalutamide, which was immediately withdrawn and replaced with prednisolone. The patient recovered over a period of 3 months. Bicalutamide-induced interstitial pneumonitis is quite rare. However, adverse reactions to maximal androgen blockade therapy should be considered and appropriate treatment for interstitial pneumonitis should be promptly initiated, as this condition is reversible.
authors.affiliation: Department of Urology, Tottori Prefectural Central Hospital, 730 Edu, Tottori, Tottori 680-0901, Japan. masagot@pref.tottori.jp
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Masago
authors.forename: Takeshi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Nemoto
authors.forename: Kinya
authors.initials: K
authors.lastname: Motoda
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000813:Anilides / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000556:secondary; D002369:Castration; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced*; D008297:Male; D009570:Nitriles / Q000008:administration & dosage / Q000009:adverse effects*; D010243:Paralysis / Q000150:complications; D011239:Prednisolone / Q000627:therapeutic use; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D014105:Tosyl Compounds / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000726:Androgen Antagonists; D000813:Anilides; D009570:Nitriles; D014105:Tosyl Compounds; D011239:Prednisolone; C053541:bicalutamide; D017430:Prostate-Specific Antigen