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Multiple pulmonary nodules: An unusual presentation of fludarabine pulmonary toxicity: Case report and review of literature
Author(s) -
Garg Sandeep,
Garg Manisha S.,
Basmaji Neil
Publication year - 2002
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.10144
Subject(s) - fludarabine , medicine , pulmonary toxicity , cladribine , chronic lymphocytic leukemia , discontinuation , hypersensitivity pneumonitis , lung , interstitial lung disease , pathology , gastroenterology , chemotherapy , leukemia , cyclophosphamide
Fludarabine monophosphate, a purine analogue is used in the treatment of lymphoid malignancies. A 73‐year‐old woman presented with fever and cough 2 weeks after completing the third cycle of fludarabine for chronic lymphocytic leukemia (CLL). Chest roentgenogram showed multiple pulmonary nodules. Pulmonary histopathology demonstrated a mononuclear interstitial infiltrate without evidence of malignant, infectious, granulomatous, or vascular causes. Her symptoms and pulmonary nodules resolved following treatment with corticosteroids. To our knowledge, four cases of interstitial pneumonitis associated with fludarabine have been reported in medical literature. Fludarabine induced lung toxicity must be considered in all patients who develop unexplained lung disease while receiving fludarabine. It is reversible with discontinuation of drug and administration of corticosteroids. This case extends the spectrum of fludarabine pulmonary toxicity to include pulmonary nodules. Am. J. Hematol. 70:241–245, 2002. © 2002 Wiley‐Liss, Inc.