title: [A case of alveolar hemorrhage caused by gefitinib].
abstract: Although drug-induced interstitial pneumonitis caused by gefitinib is well recognized in Japan, reports of alveolar hemorrhage caused by gefitinib are very rare. We encountered a case of alveolar hemorrhage thought to be caused by gefitinib. A 74-year-old woman with non-small cell lung cancer (adenocarcinoma; cT4NOM0, stage IIIB) had been receiving gefitinib as second-line therapy from January 2009. However, bloody sputum and nasal bleeding were observed 2 weeks after the initiation of gefitinib therapy. Chest radiography and computed tomography revealed ground-glass opacities predominantly in the lower lung fields. Bronchoscopy was performed, and the bronchoalveolar lavage fluid obtained from the right B8 was bloody. Her symptoms and chest ground-glass opacities improved after the withdrawal of gefitinib. Based on these clinical findings, we diagnosed alveolar hemorrhage caused by gefitinib. If chest radiography or computed tomography findings of gefitinib-treated patients show ground-glass opacities, the possibility of not only interstitial pneumonitis, but also alveolar hemorrhage should be considered in the differential diagnosis.
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Fukuoka-Higashi Medical Center.
authors.forename: Yoritake
authors.initials: Y
authors.lastname: Sakoda
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kitasato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kawano
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mizuta
authors.forename: Shohei
authors.initials: S
authors.lastname: Takata
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kawasaki
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy; D005260:Female; D000077156:Gefitinib; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced*; D008175:Lung Neoplasms / Q000188:drug therapy; D011650:Pulmonary Alveoli; D011799:Quinazolines / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib