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Interstitial lung disease: case report A 44-year-old man developed interstitial lung disease following treatment with gefitinib, and erlotinib for lung adenocarcinoma with right pleural seeding [routes not stated]. The man initially received cisplatin and docetaxel for lung adenocarcinoma with right pleural seeding; after disease progression, gefitinib 250 mg/day was initiated as second-line therapy. Three weeks later, he experienced exertional dyspnoea. Extensive left lung interstitial infiltration with right loculated pleural effusion was observed by chest x-ray; CT imaging revealed bilateral ground-glass opacities. The impression was gefitinib-induced interstitial pneumonitis. Gefitinib was withdrawn, and methylprednisolone was initiated. The man’s dyspnoea regressed after 6 days; a repeat x-ray showed regression of interstitial lung disease. Erlotinib 75 mg/day was subsequently initiated with steroid therapy. Dyspnoea and hypoxaemia recurred 2 weeks later; a repeat CT confirmed interstitial lung disease recurrence. Erlotinib was discontinued, and steroids were initiated. His symptoms regressed, and he returned home after 1 week. Author comment: "In our report, both gefitinib and erlotinib have the potential of inducing ILD [interstitial lung disease] in one patient." Wang K-F, et al. Both gefitinib and erlotinib induced drug-related interstitial lung disease in a patient with pulmonary adenocarcinoma. Journal of the Chinese Medical Association 76: 173-175, No. 3, Mar 2013. Available from: URL: http:// 803086888 dx.doi.org/10.1016/j.jcma.2013.01.012 - Taiwan

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Reactions 18 May 2013 No. 1452