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Abstract

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Article in Japanese

Case Report

A case of paclitaxel-induced pneumonitis

Natsuko Taniguchi1)  Naofumi Shinagawa1)  Ichiro Kinoshita1)  Yasuyuki Nasuhara1)  Koichi Yamazaki1)  Etsuro Yamaguchi1)  Hirotoshi Akita2)  Masaharu Nishimura1) 

1)First Department of Medicine, Hokkaido University School of Medicine
2)Department of Medical Oncology, Hokkaido University Graduate School of Medicine
North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan

ABSTRACT

A 79-year-old woman with small-cell lung cancer was treated weekly with paclitaxel after previous treatment with carboplatin and etoposide. Within the first course of paclitaxel, chest radiography and CT revealed thickening of the bronchovascular bundle and interlobular septa, and infiltrates in both lung fields. A marked increase in the number of lymphocytes was found on bronchoalveolar lavage (BAL). Microorganisms such as Cytomegalovirus, Mycobacteria, and Pneumocystis carinii were absent from the BAL fluid. Interstitial infiltration was partially improved simply by stopping paclitaxel administration, without the need for any additional therapy. Drug-induced pneumonitis caused by paclitaxel was diagnosed on the basis of the clinical course and findings, although a drug lymphocyte stimulation test yielded negative results for paclitaxel. Interstitial infiltrates on imaging, symptoms and arterial blood gas results improved with administration of oral prednisolone. The possibility of pneumonitis induced by paclitaxel should be considered even in cases without interstitial lung disease.

KEYWORDS

Drug-induced pneumonitis  Interstitial pneumonitis  Paclitaxel  Drug lymphocyte stimulation test 

Received 平成15年1月16日

JJRS, 42(2): 158-163, 2004

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