Open AccessThalidomide-induced bronchiolitis obliterans organizing pneumonia in a patient with multiple myeloma
Author(s) -
Z. El Ati,
L. Raîs,
J. Chérif,
H. Jbali,
L. Ben Fatma,
I. Mami,
R. Khedher,
W. Smaoui,
M. Krid,
Fethi Ben Hamida,
S. Boussaid,
Mohamed Karim Zouaghi
Publication year - 2019
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.265477
Subject(s) - medicine , thalidomide , bronchiolitis obliterans organizing pneumonia , multiple myeloma , bronchiolitis obliterans , surgery , cryptogenic organizing pneumonia , crackles , lung , lung transplantation
Thalidomide, which is an angiogenesis inhibitor and immunomodulator that reduces tumor necrosis factor-alpha, has regained value in the treatment of multiple myeloma. Serious pulmonary complications due to thalidomide use remain relatively uncommon. We describe a case of bronchiolitis obliterans organizing pneumonia (BOOP) due to thalidomide. A 51-year-old man with IgG lambda myeloma was treated with thalidomide and dexamethasone. Seven days after the beginning of chemotherapy, the patient presented a fever and a persistent cough. Auscultation revealed crackles in both pulmonary bases. The chest X-ray showed a diffuse bilateral alveolar-interstitial syndrome. Computed tomography scan revealed bilateral pulmonary involvement, with bilateral interstitial alveolar infiltration and ground-glass pattern consolidations. Pulmonary infection, malignant tumor, and lung involvement of multiple myeloma were excluded through various tests. Thalidomide-induced BOOP was suspected, and the drug was withdrawn and replaced by Melphalan. The patient had complete resolution of his symptoms and radiologic pulmonary involvement on discontinuation of the drug. In the absence of other etiologies, physicians should be cognizant of this potential complication in patients receiving thalidomide who present with respiratory symptoms.