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A case of interstitial lung disease with alveolar hemorrhage induced by pembrolizumab

Authors Sugano T, Seike M, Noro R, Kaburaki S, Tozuka T, Takahashi A, Takano N, Tanaka T, Kashiwada T, Takeuchi S, Minegishi Y, Saito Y, Kubota K, Terasaki Y, Gemma A

Received 27 March 2018

Accepted for publication 31 May 2018

Published 17 September 2018 Volume 2018:11 Pages 5879—5883

DOI https://doi.org/10.2147/OTT.S169321

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Yao Dai


Teppei Sugano,1 Masahiro Seike,1 Rintaro Noro,1 Syota Kaburaki,1 Takehiro Tozuka,1 Akihiko Takahashi,1 Natsuki Takano,1 Toru Tanaka,1 Takeru Kashiwada,1 Susumu Takeuchi,1 Yuji Minegishi,1 Yoshinobu Saito,1 Kaoru Kubota,1 Yasuhiro Terasaki,2 Akihiko Gemma1

1Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan; 2Department of Analytic Human Pathology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan

Abstract: We herein describe the case of a 67-year-old woman with advanced lung adenocarcinoma who developed interstitial lung disease (ILD) with alveolar hemorrhage induced by pembrolizumab. She received four courses of pembrolizumab therapy and achieved a partial response. She had no respiratory symptoms; however, chest radiography and computed tomography (CT) revealed ground-glass opacities (GGOs) and crazy-paving pattern. Based on findings of bloody bronchoalveolar lavage fluid and transbronchial lung biopsy samples, pembrolizumab-induced ILD with alveolar hemorrhage was diagnosed. Corticosteroid therapy rapidly improved alveolar hemorrhage and regressed GGOs on CT scan. This is the first report on ILD with alveolar hemorrhage induced by pembrolizumab.

Keywords:
pembrolizumab, PD-1, pneumonitis, alveolar hemorrhage

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