Bortezomib
- PDF / 171,271 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 14 Downloads / 145 Views
1 S
Lung injury: case report A 58-year-old woman developed severe lung injury during treatment with bortezomib for multiple myeloma (MM). The woman, who was diagnosed with MM (λ-light chain) on 25 February 2019, started receiving chemotherapy with bortezomib [dosage and route not stated] and dexamethasone from 05 March 2019. On day 4 of the chemotherapy (08 March 2019), she experienced chest tightness, shortness of breath, cough and expectoration. Physical examination revealed a small amount of moist rales. Chest CT scan revealed patchy fuzzy shadows of both the lungs with pleural effusion. Her oxygen saturation was 91%, without oxygen inhalation. Laboratory investigations were as follows: brain natriuretic peptide (BNP) 1238.65 pg/mL, uric acid 0.93 mmol/L, creatinine 428 µmol/L, blood calcium 2.7 mmol/L and blood potassium 3.8 mmol/L. Left ventricular insufficiency, pulmonary oedema and lung infection were presumed. The woman was started on high-throughput oxygen inhalation via nasal catheter. She also received unspecified hormonal therapy and unspecified diuretics along with an anti-infective treatment with cefoperazone [cefoperazone sodium] and sulbactam [Sulperazon; sulbactam sodium]. Her daily output improved and her body temperature was normal even after stopping the unspecified hormonal therapy. However, the chest tightness did not improve. On day 8 of the chemotherapy (12 March 2019), her chest tightness exacerbated along with shortness of breath. Physical examination showed significantly increased rales in both lungs. Laboratory investigations were as follows: potassium 3.4 mmol/L, creatinine 482 µmol/L, uric acid 0.88 mmol/L, calcium 2.53 mmol/L and phosphorus 1.31 mmol/L and BNP 351.33 pg/mL. Blood gas analysis showed pH 7.49, PCO2 43.70mm Hg and PO2 48.70mm Hg. A chest CT scan revealed scattered inflammation and local consolidation of both the lungs, which progressed more than before. After diuretic and anti-infective treatment, the BNP decreased, but progressive worsening was observed in the lungs. Left ventricular insufficiency and lung infection were ruled out, and a diagnosis of bortezomib-induced severe lung injury was confirmed. Bortezomib was discontinued, and she was treated with high-throughput oxygen inhalation, unspecified hormone therapy and methylprednisolone. Her symptoms including chest tightness and shortness of breath gradually improved. After 4 days, the symptoms completely resolved. Oxygen partial pressure was noted to be 99mm Hg, and chest CT revealed a significant improvement on day 12. The oxygen inhalation was stopped and methylprednisolone was reduced gradually. Thereafter, she did not experienced recurrence. Baojing D, et al. Bortezomib-associated lung injury: Report of one case and review of literature. Journal of Leukemia and Lymphoma 29: 251-254, No. 4, 2020. Available 803514291 from: URL: http://doi.org/10.3760/cma.j.cn115356-20190910-00178 [Chinese; summarised from a translation]
0114-9954/20/1830-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserve
Data Loading...
