title: Temozolomide-associated bronchiolitis obliterans organizing pneumonia successfully treated with high-dose corticosteroid.
abstract: Temozolomide is an oral alkylating agent with clinical activity against glioblastoma multiforme (GM). It is generally well-tolerated and has few pulmonary side effects. We report a case of temozolomide-associated brochiolitis obliterans organizing pneumonia (BOOP) requiring very high-dose corticosteroid treatment. A 56-yr-old woman presented with a 2-week history of exertional dyspnea. For the treatment of GM diagnosed 4 months previously, she had undergone surgery followed by chemoradiotherapy, and then planned adjuvant chemotherapy with temozolomide. After the 1st cycle, progressive dyspnea was gradually developed. Chest radiograph showed diffuse patchy peribronchovascular ground-glass opacities in both lungs. Conventional dose of methylprednisolone (1 mg/kg/day) was begun for the possibility of BOOP. Although transbronchial lung biopsy findings were compatible with BOOP, the patient's clinical course was more aggravated until hospital day 5. After the dose of methylprednisolone was increased (500 mg/day for 5 days) radiologic findings were improved dramatically.
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Tae-Ok
authors.initials: TO
authors.lastname: Kim
authors.forename: In-Jae
authors.initials: IJ
authors.lastname: Oh
authors.forename: Hyun-Wook
authors.initials: HW
authors.lastname: Kang
authors.forename: Su-Young
authors.initials: SY
authors.lastname: Chi
authors.forename: Hee-Jung
authors.initials: HJ
authors.lastname: Ban
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Kwon
authors.forename: Kyu-Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: Yu-Il
authors.initials: YI
authors.lastname: Kim
authors.forename: Sung-Chul
authors.initials: SC
authors.lastname: Lim
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Kim
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects* / Q000627:therapeutic use; D018549:Cryptogenic Organizing Pneumonia / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D000077204:Temozolomide; D014057:Tomography, X-Ray Computed
chemical_list: D018906:Antineoplastic Agents, Alkylating; D005938:Glucocorticoids; D003606:Dacarbazine; D008775:Methylprednisolone; D000077204:Temozolomide