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Acute lung injury associated with 5-fluorouracil and oxaliplatinum combined chemotherapy

¹ Dept Thoracic Diseases and ⁵ Anatomic Pathology, Bellaria and Maggiore Hospitals, Bologna, Italy; ² Dept Respiratory Diseases, S. Matteo University Hospital, Pavia, Italy; ³ Dept of Oncology, City Hospital, Rimini, Italy; ⁴ Institute of Hematology and Clinical Oncology "L & A Seragnoli", S. Orsola University Hospital, Bologna, Italy

CORRESPONDENCE: V. Poletti, Dept of Thoracic Diseases, Bellaria and Maggiore Hospital, Largo Nigrisoli 2, 40133, Bologna, Italy. Fax: 39 0516478727

Keywords: chemotherapy, diffuse alveolar damage, drug-induced toxicity, 5-fluorouracil, oxaliplatinum, rectum carcinoma

Received: January 22, 2001
Accepted February 19, 2001

Abstract

Diarrhoea, T-CD4+ lymphopenia and bilateral patchy pulmonary infiltrates developed in a male 60 yrs of age, who was treated with oxaliplatinum and 5-fluorouracil for unresectable rectum carcinoma. The findings from transbronchial lung biopsy and bronchoalveolar lavage (BAL) were consistent with an organizing diffuse alveolar damage pattern. Once extensive microbiological studies proved negative, corticosteroids were given and a complete remission of clinical and radiological abnormalities was achieved. It is concluded that the aforementioned pathological manifestations were due to chemotherapy and included a pulmonary adverse reaction, a feature never previously associated with oxaliplatinum and 5-fluorouracil regimens.

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