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Nonspecific interstitial pneumonitis after bortezomib and thalidomide treatment in a multiple myeloma patient

Authors
 Wonseok Kang  ;  Jin Seok Kim  ;  Sang Ho Cho  ;  Sung Kyu Kim  ;  Joon Chang  ;  Moo Suk Park 
Citation
 YONSEI MEDICAL JOURNAL, Vol.51(3) : 448-450, 2010 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2010
MeSH
Aged ; Boronic Acids/adverse effects* ; Boronic Acids/therapeutic use ; Bortezomib ; Dexamethasone/therapeutic use ; Humans ; Lung Diseases, Interstitial/chemically induced* ; Male ; Multiple Myeloma/drug therapy* ; Pyrazines/adverse effects* ; Pyrazines/therapeutic use ; Thalidomide/adverse effects* ; Thalidomide/therapeutic use
Keywords
Interstitial lung diseases ; thalidomide ; bortezomib ; multiple myeloma ; adverse effects
Abstract
Bortezomib, an inhibitor of 26S proteosome, is recently approved treatment option for multiple myeloma. Thalidomide, a drug with immunomodulating and antiangiogenic effects, has also shown promise as an effective treatment in multiple myeloma. Pulmonary complications are believed to be rare, especially interstitial lung disease. Here, we describe a patient with dyspnea and diffuse pulmonary infiltrates while receiving bortezomib and thalidomide in combination with dexamethasone for treatment-naïve multiple myeloma. Bronchoalveolar lavage demonstrated a significant decrease in the ratio of CD4 : CD8 T lymphocytes (CD4/8 ratio, 0.54). Extensive workup for other causes, including infections, was negative. A lung biopsy under video-assisted thorascopic surgery revealed a diagnosis of nonspecific interstitial pneumonitis. The symptoms and imaging study findings improved after initiating steroid treatment. Physicians should be aware of this potential complication in patients receiving the novel molecular-targeted antineoplastic agents, bortezomib and thalidomide, who present with dyspnea and new pulmonary infiltrates and fail to improve despite treatment with broad-spectrum antibiotics
Files in This Item:
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DOI
10.3349/ymj.2010.51.3.448
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Won Suk(강원석)
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Cho, Sang Ho(조상호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100888
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