Androgen deprivation therapy, which is the standard treatment for metastatic prostate cancer, includes nonsteroidal antiandrogenic drugs, such as flutamide, nilutamide and bicalutamide. Of them, bicalutamide rarely induces interstitial pneumonia. We report a case of bicalutamide-induced interstitial pneumonia. A 68-year old male diagnosed with prostate cancer and multiple bone metastases presented with dry cough and low grade fever for 3 days. He had taken bicalutamide (50 mg/day) for 13 months. High resolution computed tomography revealed ground glass opacity in his right upper lung. The laboratory studies showed no eosinophilia in the serum and bronchoalveolar lavage fluid. Despite the use of antimicrobial agents for 2 weeks, the extent of the lung lesions increased to the left upper and right lower lung. He had no environmental exposure, collagen vascular disease and microbiological causes. Under the suspicion of bicalutamide-induced interstitial pneumonia, bicalutamide was stopped and prednisolone (1 mg/kg/day) was initiated. The symptoms and radiologic abnormalities were resolved with residual minimal fibrosis.
Anilides ; Anti-Infective Agents ; Bronchoalveolar Lavage Fluid ; Collagen ; Cough ; Environmental Exposure ; Eosinophilia ; Fever ; Fibrosis ; Flutamide ; Glass ; Humans ; Imidazolidines ; Lung ; Lung Diseases, Interstitial ; Male ; Neoplasm Metastasis ; Nitriles ; Prednisolone ; Prostatic Neoplasms ; Tosyl Compounds ; Vascular Diseases

BACKGROUND: An elevated plasma plasminogen activator inhibitor-1 (PAI-1) concentration has been identified as a factor for the development of macroangiopathy including myocardial infarction, and an association between polymorphism of the PAI-1 promoter and plasma PAI-1 levels has been described. PAI-1 gene is thought to be one of candidate genes in development of diabetic nephropathy. We studied association between polymorphism of PAI-1 promoter and the development of diabetic renal failure in type 2 DM. METHODS: We reviewed the past clinical records of 4, 500 diabetic patients who were registered in KyungHee university hospital. We selected 85 diabetic patients without nephropathy for more than 10 years and 92 diabetic patients in which Kidney failure was developed within 20 years. We investigated promoter -675 and -844 region polymorphisms in type 2 DM patients with ESRD compared with patients without nephropathy by using PCR-RLFP. RESULTS: The genotypes of group of type 2 DM with ESRD and control group were consistent with Hardy-Weingerg equation. There was no significant difference between two groups in the polymorphisms of PAI-I promoter -675 region. Similarly, there was no significant difference between two groups in the polymorphisms of PAI-I promoter -844 region. CONCLUSION: The results suggest that the polymorphisms of PAI-1 gene are not associated with development of diabetic renal failure in Korean patients with type 2 DM.
Diabetic Nephropathies ; Genotype ; Humans ; Kidney Failure, Chronic ; Myocardial Infarction ; Plasma ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Renal Insufficiency*