title: Alveolar hemorrhage associated with pemetrexed administration.
abstract: We herein describe a 67-year-old man with advanced adenocarcinoma of the lung who developed an alveolar hemorrhage (AH) associated with pemetrexed. He received four courses of pemetrexed therapy with carboplatin and seven courses of pemetrexed maintenance therapy. One week after the last pemetrexed administration, the patient developed hemoptysis with deteriorating dyspnea and anemia. Chest images showed diffuse ground-glass attenuation. The diagnosis of AH was based on findings of bloody bronchoalveolar lavage (BAL) fluid, hemosiderin-laden macrophages in the BAL fluid, and a transbronchial lung biopsy sample. This report is the first to describe AH associated with pemetrexed.
authors.affiliation: Department of Medical Oncology, Graduate School of Medicine, Chiba University, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Kurimoto
authors.forename: Ikuo
authors.initials: I
authors.lastname: Sekine
authors.forename: Shunichiro
authors.initials: S
authors.lastname: Iwasawa
authors.forename: Emiko
authors.initials: E
authors.lastname: Sakaida
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tada
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tatsumi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nakatani
authors.forename: Chiaki
authors.initials: C
authors.lastname: Imai
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takiguchi
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000740:Anemia / Q000139:chemically induced; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid; D016190:Carboplatin / Q000008:administration & dosage; D004417:Dyspnea / Q000139:chemically induced; D005971:Glutamates / Q000009:adverse effects*; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives*; D006469:Hemoptysis / Q000139:chemically induced; D006470:Hemorrhage / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000473:pathology; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed; D011650:Pulmonary Alveoli; D014057:Tomography, X-Ray Computed
chemical_list: D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D016190:Carboplatin