Rituximab-induced interstitial lung disease:A case report and literature review
10.13481/j.1671-587x.20170636
- VernacularTitle:利妥昔单抗致间质性肺疾病1例报告及文献复习
- Author:
Yinyin PENG
1
;
Liping CHEN
;
Lin LIU
;
Jianbin CHEN
;
Yajuan CHEN
;
Xiaoli HAN
;
Qing XIAO
Author Information
1. 重庆医科大学附属第一医院血液内科
- Keywords:
rituximab;
lymphoma;
interstitial lung disease;
hemopoietic stem cell transplantation;
infection
- From:
Journal of Jilin University(Medicine Edition)
2017;43(6):1260-1264
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To discuss the pathogenesis,clinical manifestations,diagnosis,differential diagnosis, treatment,and prognosis of the patient with rituximab (RTX)-induced interstitial lung disease (ILD) (RTX-ILD).Methods:A male patient aged 19 years old was confirmed as classical Hodgkin's lymphoma more than 2 years ago,and received autologous hemopoietic stem cell transplantation (HSCT)when the disease recurred 1 year ago.Two months after HSCT,the maintenance chemotherapy was given every month with 375 mg· m-2 RTX,but the mediastinal recurrence appeared during the period,then the mediastinal residual lesion radiotherapy was done for 10 times.However,8 d after the third RTX chemotherapy,the patient experienced post-exercising tachypnea,fever,cough,chest congestion,and limb weakness.The chest CT scanning results suggested ground gloss opacity on both lungs,and blood gas analysis suggested a hypoxemia.Neither antibacterial nor antifungal treatment worked well.Afterwards,the sequential etiological examination showed the negative results,and the bronchoscope examination showed the normal results as well.Considering about the possibility of RTX-ILD,RTX was stopped immediately and turned to intravenous infusion of methylprednisolone 40 mg per day.Results:Five d later,the symptoms of the patients were improved,and the follow-up methylprednisolone was changed to oral and gradually reduced to discontinuation.Conclusion:RTX-ILD is relatively rare,and its clinical manifestations lack specificity. Hormonotherapy is the main method in treatment of RTX-ILD. The patients sensitive to hormonotherapy have better prognosis than those insensitive to hormonotherapy.
