Gemcitabine
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Interstitial pneumonitis in an elderly patient: case report A 70-year-old man developed interstitial pneumonitis during gemcitabine therapy for bile duct cancer. The man, who had undergone pancreaticoduodenectomy in August 2007 for stage I lower bile duct cancer, started receiving adjuvant gemcitabine 1000 mg/m2 once weekly for 3 weeks [route of administration not stated] 2 months later. In October 2008, he developed dyspnoea on exertion. Suspecting drugrelated pulmonary injury, gemcitabine was discontinued. A month later, his dyspnoea worsened. Investigations revealed an SpO2 of 68%, a PaO2 of 34.6mm Hg and elevated CRP, LDH and KL-6 levels. Chest X-ray and CT scans were confirmatory, and he was admitted for druginduced interstitial pneumonitis. Eight days after admission, his dyspnoea deteriorated further, necessitating intubation and mechanical ventilation. After methylprednisolone pulse therapy was started, the man’s condition significantly improved and he was extubated 6 days later. His steroid dosage was tapered after 2 weeks and switched to oral therapy. He was discharged on hospital day 24. Two years after the surgery, the patient has survived with no disease recurrence. Mori R, et al. A case of drug-induced interstitial pneumonitis after adjuvant chemotherapy with gemcitabine for bile duct cancer. Gan to Kagaku Ryoho 37: 923-6, No. 5, May 2010 [Japanese; summarised from a translation] 803028044 Japan
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Reactions 31 Jul 2010 No. 1312
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