Fatal gemcitabine-induced pulmonary toxicity in metastatic gallbladder adenocarcinoma

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dc.contributor.authorFerreira Galvo, Flavio Henrique
dc.contributor.authorMedina Pestana, Jose Osmar [UNIFESP]
dc.contributor.authorCapelozzi, Vera Luiza
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T13:59:11Z
dc.date.available2016-01-24T13:59:11Z
dc.date.issued2010-02-01
dc.description.abstractGemcitabine is a chemotherapy agent that may cause unpredictable side effects. in this report, we describe a fatal gemcitabine-induced pulmonary toxicity in a patient with gallbladder metastatic adenocarcinoma. A 72-year-old patient was submitted to an elective laparoscopic cholecystectomy, and a tubular adenocarcinoma in the gallbladder was incidentally diagnosed. CT scan and ultrasound before the surgery did not show any tumor. After the surgery a Pet scan was positive for a hot-spot in the left colon. the colonic lesion was conveniently removed and the histology evaluation confirmed the diagnosis of adenocarcinoma tubular. the patient was then submitted to three sections of 1,600 mg/m(2) of gemcitabine with intervals of 1 week. Three weeks later he developed severe respiratory distress. A helicoidal CT scan showed diffuse and severe interstitial pneumonitis, and lung biopsy confirmed accelerated usual interstitial pneumonia consistent with drug-induced toxicity. the patient presented unfavorable evolution with progressive worsening of respiratory function, hypotension, and renal failure. He died 1 month later in spite of methylprednisolone pulse therapy, large spectrum antimicrobial therapy, and full support of respiratory, hemodynamic and renal systems. Gemcitabine-induced pulmonary toxicity is usually a dramatic condition. Physicians should suspect pulmonary toxicity in patients with respiratory distress after gemcitabine chemotherapy, mainly in elderly patients.en
dc.description.affiliationUniv São Paulo, Fac Med, Disciplina Transplante & Cirurgia Figado, BR-01246003 São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Sch Med, Dept Gastroenterol, BR-01246003 São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Nephrol, São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Sch Med, Dept Pathol, BR-01246003 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Nephrol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent607-610
dc.identifierhttp://dx.doi.org/10.1007/s00280-009-1167-6
dc.identifier.citationCancer Chemotherapy and Pharmacology. New York: Springer, v. 65, n. 3, p. 607-610, 2010.
dc.identifier.doi10.1007/s00280-009-1167-6
dc.identifier.fileWOS000273031400024.pdf
dc.identifier.issn0344-5704
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/32184
dc.identifier.wosWOS:000273031400024
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofCancer Chemotherapy and Pharmacology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.licensehttp://www.springer.com/open+access/authors+rights?SGWID=0-176704-12-683201-0
dc.subjectChemotherapy toxicityen
dc.subjectGemcitabineen
dc.subjectPneumonitisen
dc.subjectGallbladder metastasisen
dc.subjectColon canceren
dc.titleFatal gemcitabine-induced pulmonary toxicity in metastatic gallbladder adenocarcinomaen
dc.typeinfo:eu-repo/semantics/article
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