A case report of eosinophilic pneumonia following allergic symptoms in a patient being treated with oxaliplatin, fuluorouracil, and leucovorin
Hiroyuki Itoa Joe Okumotob Shinjiro Sakamotob Takeshi Masudab Hiroshi Iwamotob Noboru Hattorib
aDepartment of Respiratory Medicine, JR Hiroshima Hospital
bDepartment of Respiratory Medicine, Hiroshima University Hospital
A 69-year-old male patient with recurrent sigmoid colon cancer after sigmoid colectomy began treatment with the oxaliplatin, fluorouracil (5-FU), and leucovorin (folinic acid) (FOLFOX) regimen. Mild generalized pruritus developed following the 7th cycle of this regimen. After receiving the 10th cycle of chemotherapy, he developed fever and dyspnea. Chest computed tomography scan revealed patchy ground-glass opacities in the bilateral lung fields. A high eosinophil count was observed in his bronchoalveolar lavage fluid. Therefore, a case of drug-induced eosinophilic pneumonia due to the FOLFOX regimen was diagnosed. Steroid therapy led to improvement in the pneumonia. Discontinuation of the oxaliplatin or steroid therapy is ineffective in some patients with FOLFOX therapy-induced lung injury, and is associated with relatively high mortality. However, the possibility of steroid-responsive eosinophilic pneumonia should be considered in patients with pulmonary infiltrate following allergic symptoms to the FOLFOX regimen.
Drug-induced eosinophilic pneumonia Oxaliplatin FOLFOX regimen
Received 2 Mar 2020 / Accepted 2 Jul 2020
AJRS, 9(5): 370-373, 2020