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Everolimus Induced Lung Disease: A Case Report
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A6629 - Everolimus Induced Lung Disease: A Case Report
Author Block: A. Ciledag1, D. Dogan Mulazimoglu1, S. Erol1, F. Ciftci1, A. Kaya1, G. Celik1, G. Utkan2, O. Kumbasar1; 1Department of Chest Diseases, Ankara University School of Medicine, Department of Chest Diseases, Ankara, Turkey, 2Department of Oncology, Ankara University School of Medicine, Department of Oncology, Ankara, Turkey.
A 67 year old female patient was admitted with dyspnea. She had a diagnosis of pancreatic neuroendocrine tumor for 3 years without any chronic disease. Initially somatostatin therapy had been given, however, due to lack of response, everolimus (an inhibitor of mammalian target of rapamycin, mTOR) had been prescribed two years ago. After 6 months of everolimus, the patient admitted with mild dyspnea. A thoracic computed tomography (CT) revealed newly developed bilateral ground glass opacities at peripheral zones of the lungs. There was no sign of infectious disease and rheumatologic pathology was ruled out. The pulmonary function test and carbon monoxide diffusion test (DLCO) was normal. A fiberoptic bronchoscopy (FOB) was recommended, but she did not accept. Because of a response in primary disease to everolimus and normal pulmonary function test, the therapy was continued. During the follow up, however, dyspnea was progressed and thoracic CT showed radiological progression with a decrease in DLCO test. A FOB was performed and bronchoalveolar lavage (BAL) was taken. Cytological examination showed lymphocytic alveolitis, with a flow cytometry of showing 48% lymphocyte and 17% eosinophil in BAL fluid, while gram staining and culture was negative. The patient was accepted as drug-induced lung disease and everolimus was stopped. After 3 months of discontinuation, there was an improvement in the patients symptoms and a control thoracic CT showed also regression in radiological findings. In conclusion, everolimus is a possible agent for drug induced-lung disease, and the patients must be followed closely for the possible development of this toxicity.
Author Block: A. Ciledag1, D. Dogan Mulazimoglu1, S. Erol1, F. Ciftci1, A. Kaya1, G. Celik1, G. Utkan2, O. Kumbasar1; 1Department of Chest Diseases, Ankara University School of Medicine, Department of Chest Diseases, Ankara, Turkey, 2Department of Oncology, Ankara University School of Medicine, Department of Oncology, Ankara, Turkey.
A 67 year old female patient was admitted with dyspnea. She had a diagnosis of pancreatic neuroendocrine tumor for 3 years without any chronic disease. Initially somatostatin therapy had been given, however, due to lack of response, everolimus (an inhibitor of mammalian target of rapamycin, mTOR) had been prescribed two years ago. After 6 months of everolimus, the patient admitted with mild dyspnea. A thoracic computed tomography (CT) revealed newly developed bilateral ground glass opacities at peripheral zones of the lungs. There was no sign of infectious disease and rheumatologic pathology was ruled out. The pulmonary function test and carbon monoxide diffusion test (DLCO) was normal. A fiberoptic bronchoscopy (FOB) was recommended, but she did not accept. Because of a response in primary disease to everolimus and normal pulmonary function test, the therapy was continued. During the follow up, however, dyspnea was progressed and thoracic CT showed radiological progression with a decrease in DLCO test. A FOB was performed and bronchoalveolar lavage (BAL) was taken. Cytological examination showed lymphocytic alveolitis, with a flow cytometry of showing 48% lymphocyte and 17% eosinophil in BAL fluid, while gram staining and culture was negative. The patient was accepted as drug-induced lung disease and everolimus was stopped. After 3 months of discontinuation, there was an improvement in the patients symptoms and a control thoracic CT showed also regression in radiological findings. In conclusion, everolimus is a possible agent for drug induced-lung disease, and the patients must be followed closely for the possible development of this toxicity.
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