Hemoptysis and acute respiratory syndrome (ARDS) as delayed-type hypersensitivity after FOLFOX4 plus bevacizumab treatment.
As there have been many multidrug regimens introduced in colorectal cancer treatment, hypersensitivity is more often encountered than in the past. Though most allergic adverse events of oxaliplatin are mainly classified as type I reaction, a limited number of case reports of type IV reaction (delayed-type hypersensitivity) have been reported. A 73-year-old man was hospitalized for receiving the third cycle of FOLFOX4 plus bevacizumab. Forty-two hours after administration, he had dyspnea and hemoptysis. Acute respiratory distress syndrome was suspected, and the patient underwent mechanical ventilation and steroid pulse therapy. Delayed-type hypersensitivity is induced by induction of inflammation via IL-1, TNF-α and IL-6. The serum level of IL-6 in patients with advanced colorectal cancers is usually greater than the normal range. Therefore, delayed-type hypersensitivity may be easily induced in those patients. We should pay special attention to delayed-type hypersensitivity in advanced colorectal cancer patients undergoing FOLFOX treatment.
Department of Surgery, Kyorin University Hospital, Tokyo, Japan.
Takaaki
T
Kobayashi
Tadahiko
T
Masaki
Koji
K
Kogawa
Hiroyoshi
H
Matsuoka
Masanori
M
Sugiyama
D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D000068258:Bevacizumab; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017809:Fatal Outcome; D005472:Fluorouracil / Q000009:adverse effects; D006469:Hemoptysis / Q000139:chemically induced*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000209:etiology*; D002955:Leucovorin / Q000009:adverse effects; D008297:Male; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000009:adverse effects; D012128:Respiratory Distress Syndrome / Q000139:chemically induced*
D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil