Nonspecific interstitial pneumonitis after bortezomib and thalidomide treatment in a multiple myeloma patient.

Abstract:

:Bortezomib, an inhibitor of 26S proteosome, is recently approved treatment option for multiple myeloma. Thalidomide, a drug with immunomodulating and antiangiogenic effects, has also shown promise as an effective treatment in multiple myeloma. Pulmonary complications are believed to be rare, especially interstitial lung disease. Here, we describe a patient with dyspnea and diffuse pulmonary infiltrates while receiving bortezomib and thalidomide in combination with dexamethasone for treatment-naïve multiple myeloma. Bronchoalveolar lavage demonstrated a significant decrease in the ratio of CD4 : CD8 T lymphocytes (CD4/8 ratio, 0.54). Extensive workup for other causes, including infections, was negative. A lung biopsy under video-assisted thorascopic surgery revealed a diagnosis of nonspecific interstitial pneumonitis. The symptoms and imaging study findings improved after initiating steroid treatment. Physicians should be aware of this potential complication in patients receiving the novel molecular-targeted antineoplastic agents, bortezomib and thalidomide, who present with dyspnea and new pulmonary infiltrates and fail to improve despite treatment with broad-spectrum antibiotics.

journal_name

Yonsei Med J

journal_title

Yonsei medical journal

authors

Kang W,Kim JS,Cho SH,Kim SK,Chang J,Park MS

doi

10.3349/ymj.2010.51.3.448

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

448-50

issue

3

eissn

0513-5796

issn

1976-2437

pii

201005448

journal_volume

51

pub_type

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