Home
|
Inbox
|
Search
|
View Abstract
Acute Respiratory Distress Syndrome Due To Ado Transtuzumab Emtancine
Description
.abstract img { width:300px !important; height:auto; display:block; text-align:center; margin-top:10px } .abstract { overflow-x:scroll } .abstract table { width:100%; display:block; border:hidden; border-collapse: collapse; margin-top:10px } .abstract td, th { border-top: 1px solid #ddd; padding: 4px 8px; } .abstract tbody tr:nth-child(even) td { background-color: #efefef; } .abstract a { overflow-wrap: break-word; word-wrap: break-word; }
A6909 - Acute Respiratory Distress Syndrome Due To Ado Transtuzumab Emtancine
Author Block: K. Yashi1, J. Virk2, I. G. Amzuta3; 1Internal medicine, SUNY Upstate Medical University, Syracuse, NY, United States, 2SUNY Upstate Medical University, Syracuse, NY, United States, 3Pulmonary and Critical Care, SUNY Upstate Medical University, Fayetteville, NY, United States.
Introduction:
This is a case report of a patient who developed Acute respiratory distress syndrome (ARDS) as a complication from the use of drug transtuzumab emtancine (Kadcyla) which was being used for treatment of breast cancer.
Case Description:
A 72-year-old female with history of stage IIB Her 2 positive, invasive ductal carcinoma of left breast with metastasis to lymph nodes presented with dry cough and shortness of breath. Patient denied any fever, chills, sputum production, recent sick contact exposure or travel. She did not complain of chest pain or swelling of legs. She had completed 6 cycles of Kadcyla in last 4 months and had completed 4 weeks of radiation therapy for breast cancer. At presentation, she was afebrile, heart rate of 110, Blood pressure 110/62, Respiratory rate of 18, and saturating at 92 % on 4 Liters O2 (Patient did not use oxygen at baseline). On exam, she had scattered crackles on both sides of lungs but did not have elevated jugular venous distention or pedal edema.
Initial lab result showed a normal WBC count, hematocrit and a metabolic panel. Chest X ray showed confluent opacities, predominantly in peripheries. Empiric antibiotics were started but blood cultures were negative from admission. An echocardiogram showed normal systolic function and no valvular abnormalities. CT thorax showed multifocal reticular and ground glass opacities with a peripheral and apical predominance suggesting inflammatory pneumonitis. Bronchoscopy showed normal mucosa with no endobronchial lesions or excessive secretions. Patient’s oxygen requirement increased after bronchoscopy and she was intubated. The patient developed ARDS and was transferred to intensive care unit. Bronchioalveolar lavage (BAL) culture and examination was negative for bacterial, fungal, viral, tubercular infections. Transbronchial lung biopsy showed no evidence of infection or malignancy. At this point, it was thought that pneumonitis was from chemotherapeutic agent, Kadcyla, as all other causes for development of ARDS were ruled out. The patient’s condition continued to deteriorate and eventually the patient passed away.
Discussion:
We believe that Kadcyla is the likely cause for ARDS in our patient as an extensive work up failed to show any other cause. Through this case we want to add to the limited evidence of severe pneumonitis leading to ARDS from the use of Kadcyla.
Author Block: K. Yashi1, J. Virk2, I. G. Amzuta3; 1Internal medicine, SUNY Upstate Medical University, Syracuse, NY, United States, 2SUNY Upstate Medical University, Syracuse, NY, United States, 3Pulmonary and Critical Care, SUNY Upstate Medical University, Fayetteville, NY, United States.
Introduction:
This is a case report of a patient who developed Acute respiratory distress syndrome (ARDS) as a complication from the use of drug transtuzumab emtancine (Kadcyla) which was being used for treatment of breast cancer.
Case Description:
A 72-year-old female with history of stage IIB Her 2 positive, invasive ductal carcinoma of left breast with metastasis to lymph nodes presented with dry cough and shortness of breath. Patient denied any fever, chills, sputum production, recent sick contact exposure or travel. She did not complain of chest pain or swelling of legs. She had completed 6 cycles of Kadcyla in last 4 months and had completed 4 weeks of radiation therapy for breast cancer. At presentation, she was afebrile, heart rate of 110, Blood pressure 110/62, Respiratory rate of 18, and saturating at 92 % on 4 Liters O2 (Patient did not use oxygen at baseline). On exam, she had scattered crackles on both sides of lungs but did not have elevated jugular venous distention or pedal edema.
Initial lab result showed a normal WBC count, hematocrit and a metabolic panel. Chest X ray showed confluent opacities, predominantly in peripheries. Empiric antibiotics were started but blood cultures were negative from admission. An echocardiogram showed normal systolic function and no valvular abnormalities. CT thorax showed multifocal reticular and ground glass opacities with a peripheral and apical predominance suggesting inflammatory pneumonitis. Bronchoscopy showed normal mucosa with no endobronchial lesions or excessive secretions. Patient’s oxygen requirement increased after bronchoscopy and she was intubated. The patient developed ARDS and was transferred to intensive care unit. Bronchioalveolar lavage (BAL) culture and examination was negative for bacterial, fungal, viral, tubercular infections. Transbronchial lung biopsy showed no evidence of infection or malignancy. At this point, it was thought that pneumonitis was from chemotherapeutic agent, Kadcyla, as all other causes for development of ARDS were ruled out. The patient’s condition continued to deteriorate and eventually the patient passed away.
Discussion:
We believe that Kadcyla is the likely cause for ARDS in our patient as an extensive work up failed to show any other cause. Through this case we want to add to the limited evidence of severe pneumonitis leading to ARDS from the use of Kadcyla.
|
Home
|
Inbox
|
Search
|