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Abstract

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Article in Japanese

Case Report

A patient with imatinib mesylate-induced pneumonitis with nodules under treatment for chronic myeloid leukemia

Akihiro Ichikawaa,*  Yuichiro Takedaa  Haruhito Sugiyamaa  Nobuyuki Kobayashia  Risen Hiraib  Tohru Ikaric 

aDepartment of Respiratory Medicine, National Center for Global Health and Medicine
bDepartment of Hematology, National Center for Global Health and Medicine
cDepartment of Pathology, National Center for Global Health and Medicine
*Present address: Department of Respiratory Medicine, The Jikei University Katsushika Medical Center

ABSTRACT

A 77-year-old woman with chronic myeloid leukemia was treated with 400 mg/day of imatinib mesylate from November 2, 2010. She had dyspnea from March 2011. On April 12, reticular opacities appeared in her chest X-ray, and her symptoms got worse. The X-ray films and high-resolution computed tomography (HRCT) of her chest showed ground-glass opacities in the bilateral lung field with 2 cm of nodule in the right S6b segment with 4 small nodules. These findings suggested imatinib-induced pneumonitis with some infectious or granulomatous disease. Imatinib was discontinued from April 25. A transbronchial lung biopsy specimen from ground-glass opacities and an endobronchial ultrasound-guided sheath biopsy specimen from a big nodule demonstrated both interstitial pneumonia findings. Under diagnosis of imatinib-induced pneumonitis with nodules, 30 mg/day of prednisolone was given from April 29. The ground-glass opacities disappeared 4 weeks later, and it took 3 months to improve a big nodule by HRCT of her chest. Reports of imatinib-induced pneumonitis with nodules are becoming less frequent. It was necessary to treat the above pneumonitis by steroid therapy because improvement of the nodular lesion took longer than that of ground-glass opacities.

KEYWORDS

Drug-induced respiratory disease  Imatinib mesylate  Nodular lesion  Interstitial pneumonia 

Received 5 Apr 2013 / Accepted 23 Jun 2013

AJRS, 2(6): 794-798, 2013

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