Autor: |
Jouneau S, Vauléon E, Caulet-Maugendre S, Polard E, Volatron AC, Meunier C, Tattevin P, Montani D, Garin E, Raoul JL, Delaval P, Jouneau, Stéphane, Vauléon, Elodie, Caulet-Maugendre, Sylvie, Polard, Elisabeth, Volatron, Anne-Claire, Meunier, Catherine, Tattevin, Pierre, Montani, David, Garin, Etienne |
Zdroj: |
CHEST; Jun2011, Vol. 139 Issue 6, p1463-1469, 7p |
Abstrakt: |
Background: The drug (131)I-labeled lipiodol is used as internal radiotherapy for unresectable hepatocellular carcinoma. Although the drug was considered safe during preapproval studies, we observed several cases of interstitial pneumonia following its administration.Methods: Cases were retrospectively identified through the drug safety unit database of Rennes University Hospital.Results: From 1994 to 2009, interstitial pneumonia developed in 15 patients following (131)I-labeled lipiodol administration, with an estimated prevalence of 15.5 cases (95% CI, 7.7-23.2) per 1,000 treated patients. Mean age of the patients was 60 ± 8 years, and the male to female ratio was 6.5:1. All patients had cirrhosis, mainly related to long-term alcohol intoxication (n = 12). Most (n = 10) cases occurred after the second (131)I-labeled lipiodol injection. The median delay between last (131)I-labeled lipiodol administration and first respiratory symptoms was 30 days (interquartile range, 16.5-45 days). All patients presented with shortness of breath. Physical examination mostly revealed fever (n = 11) and bilateral crackles (n = 12). Chest CT scan showed bilateral ground-glass opacities (n = 8) with septal thickening, retraction, or both (n = 8). BAL (n = 7) was remarkable for increased neutrophils (n = 4) or CD8(+) T cell count (n = 3). Despite corticosteroids, 12 (80%) patients died, mostly of untractable respiratory failure (n = 9). Median delay between last (131)I-labeled lipiodol injection and death was 63 days (interquartile range, 34-129 days).Conclusions: Interstitial pneumonia may be a serious and not uncommon complication of (131)I-labeled lipiodol administration. [ABSTRACT FROM AUTHOR] |
Databáze: |
Complementary Index |
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