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Rituximab-induced interstitial lung disease in a patient with follicular lymphoma: A rare case report.

Aagre S, Patel A, Kendre P, Anand A - Lung India (2015 Nov-Dec)

Bottom Line: Diagnostic high-resolution computed tomography (HRCT) of the lungs revealed bilateral patchy ground glass opacities suggestive of interstitial lung disease (ILD).It was managed successfully with supplemental oxygen and corticosteroids with discontinuation of the Rituximab.Extensive review of the literature did not reveal ample of material on rituximab-induced ILD (RTX-ILD).

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Pediatric Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India.

ABSTRACT
Rituximab is a chimeric monoclonal antibody that targets CD-20 antigen expressed in more than 90% of all B cell non-Hodgkin's lymphoma (NHL). We report a case of 33-year-old female without any comorbidities, newly diagnosed with stage IIIB follicular lymphoma treated with rituximab-based chemotherapy. Patient developed exertional dyspnea and dry cough after the fourth cycle of rituximab-based chemotherapy. Diagnostic high-resolution computed tomography (HRCT) of the lungs revealed bilateral patchy ground glass opacities suggestive of interstitial lung disease (ILD). It was managed successfully with supplemental oxygen and corticosteroids with discontinuation of the Rituximab. Extensive review of the literature did not reveal ample of material on rituximab-induced ILD (RTX-ILD).

No MeSH data available.


Related in: MedlinePlus

Chest X-ray PA view after treatment with steroids showing near normal resolution of reticulo-nodular infiltrates
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Figure 3: Chest X-ray PA view after treatment with steroids showing near normal resolution of reticulo-nodular infiltrates

Mentions: Being hypoxemic at rest, patient was immediately treated with moist O2 inhalation along with intravenous methyl prednisolone (1 g daily for 3 days) in an intensive care unit. She had dramatic symptomatic improvement, so was switched to oral prednisolone at a dose of 1 mg/kg body weight for the first 2 weeks followed by gradual taper by 0.25 mg/kg body weight every two weekly. On follow-up, chest was clear on auscultation, imaging modalities showed near total resolution of ground glass opacities [Figure 3] and pulmonary function tests were within normal limits. Because of limited safety data and concern regarding possibility of severe second reaction as compared to first one, our patient was not re-challenged with rituximab. She was further treated with two cycles of CHOP regimen without any evidence of further lung injury during the treatment as well as follow-up. Currently the patient is asymptomatic for her FL, ILD and is on regular follow-up.


Rituximab-induced interstitial lung disease in a patient with follicular lymphoma: A rare case report.

Aagre S, Patel A, Kendre P, Anand A - Lung India (2015 Nov-Dec)

Chest X-ray PA view after treatment with steroids showing near normal resolution of reticulo-nodular infiltrates
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663870&req=5

Figure 3: Chest X-ray PA view after treatment with steroids showing near normal resolution of reticulo-nodular infiltrates
Mentions: Being hypoxemic at rest, patient was immediately treated with moist O2 inhalation along with intravenous methyl prednisolone (1 g daily for 3 days) in an intensive care unit. She had dramatic symptomatic improvement, so was switched to oral prednisolone at a dose of 1 mg/kg body weight for the first 2 weeks followed by gradual taper by 0.25 mg/kg body weight every two weekly. On follow-up, chest was clear on auscultation, imaging modalities showed near total resolution of ground glass opacities [Figure 3] and pulmonary function tests were within normal limits. Because of limited safety data and concern regarding possibility of severe second reaction as compared to first one, our patient was not re-challenged with rituximab. She was further treated with two cycles of CHOP regimen without any evidence of further lung injury during the treatment as well as follow-up. Currently the patient is asymptomatic for her FL, ILD and is on regular follow-up.

Bottom Line: Diagnostic high-resolution computed tomography (HRCT) of the lungs revealed bilateral patchy ground glass opacities suggestive of interstitial lung disease (ILD).It was managed successfully with supplemental oxygen and corticosteroids with discontinuation of the Rituximab.Extensive review of the literature did not reveal ample of material on rituximab-induced ILD (RTX-ILD).

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Pediatric Oncology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India.

ABSTRACT
Rituximab is a chimeric monoclonal antibody that targets CD-20 antigen expressed in more than 90% of all B cell non-Hodgkin's lymphoma (NHL). We report a case of 33-year-old female without any comorbidities, newly diagnosed with stage IIIB follicular lymphoma treated with rituximab-based chemotherapy. Patient developed exertional dyspnea and dry cough after the fourth cycle of rituximab-based chemotherapy. Diagnostic high-resolution computed tomography (HRCT) of the lungs revealed bilateral patchy ground glass opacities suggestive of interstitial lung disease (ILD). It was managed successfully with supplemental oxygen and corticosteroids with discontinuation of the Rituximab. Extensive review of the literature did not reveal ample of material on rituximab-induced ILD (RTX-ILD).

No MeSH data available.


Related in: MedlinePlus