Granulomatous Lung Disease Requiring Mechanical Ventilation Induced by a Single Application of Oxaliplatin-Based Chemotherapy for Colorectal Cancer: A Case Report
Combined chemotherapeutic regimens in conjunction with oxaliplatin are considered safe and effective treatment options in the clinical management of metastatic colorectal cancer. A 62-year-old male patient with a metastatic rectal carcinoma developed a pulmonary reaction after the first application...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Oncological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2013/683948 |
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| author | Dane Wildner Frank Boxberger Axel Wein Kerstin Wolff Heinz Albrecht Gudrun Männlein Rolf Janka Kerstin Amann Jürgen Siebler Werner Hohenberger Markus F. Neurath Richard Strauß |
| author_facet | Dane Wildner Frank Boxberger Axel Wein Kerstin Wolff Heinz Albrecht Gudrun Männlein Rolf Janka Kerstin Amann Jürgen Siebler Werner Hohenberger Markus F. Neurath Richard Strauß |
| author_sort | Dane Wildner |
| collection | DOAJ |
| description | Combined chemotherapeutic regimens in conjunction with oxaliplatin are considered safe and effective treatment options in the clinical management of metastatic colorectal cancer. A 62-year-old male patient with a metastatic rectal carcinoma developed a pulmonary reaction after the first application of the combined standard chemotherapy regimen (5-fluorouracil and sodium folinic acid as a 24 h infusion and oxaliplatin). Following the first dose of chemotherapy, the patient developed acute dyspnoea and fever. A computerised scan of the chest revealed bilateral pulmonary patchy consolidation. Despite high-dose empiric antibiotic and antimycotic treatment, no clinical improvement was seen. The patient's condition deteriorated, and he required invasive mechanical ventilation. Diagnostic thoracoscopic wedge resections were performed for further diagnosis. The histological workup revealed distinct granulomatous inflammation, but no microbial pathogens were to be found. Thereupon, a drug-induced reaction to chemotherapy was suspected and high-dose steroid treatment initiated. Subsequently, the patient's respiratory condition improved and he was extubated. The present case exemplifies the rare course of a bilateral pneumonia-like, drug-induced granulomatous reaction following a single application of oxaliplatin. In addition to the known side effects of oxaliplatin-containing combination chemotherapy, unexpected serious adverse events in the form of pulmonary toxicities should also be taken into account. |
| format | Article |
| id | doaj-art-bb72757126bd406fa3ec7c29e4f21b62 |
| institution | Kabale University |
| issn | 2090-6706 2090-6714 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Oncological Medicine |
| spelling | doaj-art-bb72757126bd406fa3ec7c29e4f21b622025-02-03T01:12:59ZengWileyCase Reports in Oncological Medicine2090-67062090-67142013-01-01201310.1155/2013/683948683948Granulomatous Lung Disease Requiring Mechanical Ventilation Induced by a Single Application of Oxaliplatin-Based Chemotherapy for Colorectal Cancer: A Case ReportDane Wildner0Frank Boxberger1Axel Wein2Kerstin Wolff3Heinz Albrecht4Gudrun Männlein5Rolf Janka6Kerstin Amann7Jürgen Siebler8Werner Hohenberger9Markus F. Neurath10Richard Strauß11Department of Medicine 1, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, GermanyDepartment of Medicine 1, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, GermanyDepartment of Medicine 1, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, GermanyDepartment of Medicine 1, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, GermanyDepartment of Medicine 1, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, GermanyDepartment of Medicine 1, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, GermanyRadiological Institute, University Hospital Erlangen, Maximiliansplatz 1, 91054 Erlangen, GermanyInstitute of Pathology, University Hospital Erlangen, Krankenhausstraße 12, 91054 Erlangen, GermanyDepartment of Medicine 1, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, GermanyDepartment of Surgery, University Hospital Erlangen, Krankenhausstraße 12, 91054 Erlangen, GermanyDepartment of Medicine 1, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, GermanyDepartment of Medicine 1, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, GermanyCombined chemotherapeutic regimens in conjunction with oxaliplatin are considered safe and effective treatment options in the clinical management of metastatic colorectal cancer. A 62-year-old male patient with a metastatic rectal carcinoma developed a pulmonary reaction after the first application of the combined standard chemotherapy regimen (5-fluorouracil and sodium folinic acid as a 24 h infusion and oxaliplatin). Following the first dose of chemotherapy, the patient developed acute dyspnoea and fever. A computerised scan of the chest revealed bilateral pulmonary patchy consolidation. Despite high-dose empiric antibiotic and antimycotic treatment, no clinical improvement was seen. The patient's condition deteriorated, and he required invasive mechanical ventilation. Diagnostic thoracoscopic wedge resections were performed for further diagnosis. The histological workup revealed distinct granulomatous inflammation, but no microbial pathogens were to be found. Thereupon, a drug-induced reaction to chemotherapy was suspected and high-dose steroid treatment initiated. Subsequently, the patient's respiratory condition improved and he was extubated. The present case exemplifies the rare course of a bilateral pneumonia-like, drug-induced granulomatous reaction following a single application of oxaliplatin. In addition to the known side effects of oxaliplatin-containing combination chemotherapy, unexpected serious adverse events in the form of pulmonary toxicities should also be taken into account.http://dx.doi.org/10.1155/2013/683948 |
| spellingShingle | Dane Wildner Frank Boxberger Axel Wein Kerstin Wolff Heinz Albrecht Gudrun Männlein Rolf Janka Kerstin Amann Jürgen Siebler Werner Hohenberger Markus F. Neurath Richard Strauß Granulomatous Lung Disease Requiring Mechanical Ventilation Induced by a Single Application of Oxaliplatin-Based Chemotherapy for Colorectal Cancer: A Case Report Case Reports in Oncological Medicine |
| title | Granulomatous Lung Disease Requiring Mechanical Ventilation Induced by a Single Application of Oxaliplatin-Based Chemotherapy for Colorectal Cancer: A Case Report |
| title_full | Granulomatous Lung Disease Requiring Mechanical Ventilation Induced by a Single Application of Oxaliplatin-Based Chemotherapy for Colorectal Cancer: A Case Report |
| title_fullStr | Granulomatous Lung Disease Requiring Mechanical Ventilation Induced by a Single Application of Oxaliplatin-Based Chemotherapy for Colorectal Cancer: A Case Report |
| title_full_unstemmed | Granulomatous Lung Disease Requiring Mechanical Ventilation Induced by a Single Application of Oxaliplatin-Based Chemotherapy for Colorectal Cancer: A Case Report |
| title_short | Granulomatous Lung Disease Requiring Mechanical Ventilation Induced by a Single Application of Oxaliplatin-Based Chemotherapy for Colorectal Cancer: A Case Report |
| title_sort | granulomatous lung disease requiring mechanical ventilation induced by a single application of oxaliplatin based chemotherapy for colorectal cancer a case report |
| url | http://dx.doi.org/10.1155/2013/683948 |
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