A Case of Diffuse Alveolar Damage Induced by Cyclophosphamide.

Bae, Sang Su; Bae, Mun Hee; Park, Hyung Suk; Park, Jeong Woong; Suh, Gee Young; Chung, Man Pyo; Han, Joung Ho; Kwon, O Jung; Lee, Kyung Soo; Rhee, Chong H

doi:1998.45.2.429

Tuberc Respir Dis > Volume 45(2); 1998 > Article

Case Report

Tuberculosis and Respiratory Diseases 1998;45(2):429-436.
DOI: https://doi.org/10.4046/trd.1998.45.2.429 Published online April 1, 1998.

A Case of Diffuse Alveolar Damage Induced by Cyclophosphamide.

Sang Su Bae, Mun Hee Bae, Hyung Suk Park, Jeong Woong Park, Gee Young Suh, Man Pyo Chung, Joung Ho Han, O Jung Kwon, Kyung Soo Lee, Chong H Rhee

¹Division of Pulmonology, Department of Medicine, Samsung Medical Center, College of Medicine, Sung Kyun Kwan University, Seoul, Korea.
²Department of Diagnostic Pathology, Samsung Medical Center, College of Medicine, Sung Kyun Kwan University, Seoul, Korea.
³Department of Radilogy, Samsung Medical Center, College of Medicine, Sung Kyun Kwan University, Seoul, Korea.

Abstract

Approximately 100 drugs have been reported to affect the lungs adversely. Among these, pulmonary toxicity caused by antieneoplastic agent is being recognized more frequently. Cyclophosphamide is an immunosuppressive alkylating agent used for the treatment of a wide variety of malignant and nonmalignant diseases. The incidence of pulmonary toxicity is probably less than 1 percent The first case was reported in 1967. Since then, more than 20 well-documented cases of pulmonary toxicity associated with cyclophosphamide have been reported in the literature. In Korea, three patients were identified with cyclophosphamide-induced lung disease. The typical features of toxicity include dyspnea, fever, cough, new parenchymal infiltrates, gas exchangs abnormalities on pulmonary function tests, and pleural thickening on chest roentgenogram. The best approach to management is early diagnosis, discontinuation of the offending drug and administration of corticosteroid therapy. Recently, we experienced a case of diffuse alveolar damage induced by cyclophosphamide. The patient presented with early-onset pulmonary toxicity and died of repiratory failure despite early use of corticosteroid.

Key Words: Cyclophosphamide, Diffuse alveolar damage, Corticosteroid