Oxaliplatin-induced diffuse alveolar hemorrhage: A case report.

IF 2.6 Q3 ONCOLOGY

World journal of clinical oncology Pub Date : 2025-04-24 DOI:10.5306/wjco.v16.i4.105077

Toshiaki Tsurui, Emiko Mura, Atsushi Horiike, Takuya Tsunoda

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引用次数: 0

Abstract

Background: Drug-induced lung injury is a common adverse effect of chemotherapeutic agents. Diffuse alveolar hemorrhage (DAH) is a fatal complication associated with drug-induced lung injury. Early diagnosis and treatment of DAH is critical, as delayed management can lead to respiratory failure and poor outcomes. However, the diagnosis of DAH is difficult because of the nonspecific clinical manifestations; as such, bronchoscopy is necessary to establish a diagnosis.

Case summary: The patient presented with fever and dry cough. He had been receiving fluoropyrimidine and oxaliplatin therapy for esophageal squamous cell carcinoma. Chest imaging revealed diffuse ground-glass opacities. Bronchoscopy with bronchoalveolar lavage was performed, which confirmed the diagnosis of DAH. Although the patient's respiratory status rapidly worsened, high-dose corticosteroid therapy with respiratory support gradually improved the patient's condition and he was successfully extubated.

Conclusion: Prompt DAH diagnosis and bronchoscopy in patients receiving oxaliplatin-containing chemotherapy presenting with acute respiratory failure are critical for improving outcomes.

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奥沙利铂致弥漫性肺泡出血1例。

背景：药物性肺损伤是化疗药物常见的不良反应。弥漫性肺泡出血（DAH）是与药物性肺损伤相关的致命并发症。早期诊断和治疗DAH至关重要，因为延迟治疗可导致呼吸衰竭和不良预后。然而，由于非特异性临床表现，DAH的诊断困难；因此，支气管镜检查对于确定诊断是必要的。病例总结：患者表现为发热和干咳。他一直接受氟嘧啶和奥沙利铂治疗食管鳞状细胞癌。胸部影像学显示弥漫性磨玻璃影。支气管镜检查伴支气管肺泡灌洗，确诊为DAH。虽然患者呼吸状况迅速恶化，但高剂量皮质类固醇治疗配合呼吸支持逐渐改善患者病情，并成功拔管。结论：在接受含奥沙利铂化疗并出现急性呼吸衰竭的患者中，及时诊断DAH并进行支气管镜检查对改善预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World journal of clinical oncology ONCOLOGY-

自引率

0.00%

发文量

585

期刊介绍： The WJCO is a high-quality, peer reviewed, open-access journal. The primary task of WJCO is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of oncology. In order to promote productive academic communication, the peer review process for the WJCO is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCO are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in oncology. Scope: Art of Oncology, Biology of Neoplasia, Breast Cancer, Cancer Prevention and Control, Cancer-Related Complications, Diagnosis in Oncology, Gastrointestinal Cancer, Genetic Testing For Cancer, Gynecologic Cancer, Head and Neck Cancer, Hematologic Malignancy, Lung Cancer, Melanoma, Molecular Oncology, Neurooncology, Palliative and Supportive Care, Pediatric Oncology, Surgical Oncology, Translational Oncology, and Urologic Oncology.