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Fibrotic Lung Toxicity Induced by Hydroxycarbamide
Elena Bargagli1, Marco Palazzi2, Francesco Perri2
1Section of Respiratory Medicine, Department of Clinical and Experimental Biomedical Sciences, Careggi University Hospital, Florence, Italy bargagli2@gmail.com.
In Vivo (Athens, Greece)
|November 6, 2017
Summary
Hydroxycarbamide (hydroxyurea) can cause severe lung toxicity, leading to acute respiratory failure. Discontinuing hydroxyurea and initiating steroid therapy rapidly improved patient outcomes.
Area of Science:
- Pulmonology
- Hematology
- Pharmacology
Background:
- Hydroxycarbamide (hydroxyurea) is a medication used to treat myeloproliferative neoplasms like chronic myelomonocytic leukemia.
- The use of hydroxycarbamide is expanding to various systemic disorders, necessitating a thorough understanding of its adverse effects.
Observation:
- A patient with chronic myelomonocytic leukemia developed severe dyspnea and acute respiratory failure after four months of hydroxycarbamide treatment.
- Chest CT revealed diffuse ground glass opacities and centrilobular nodules, suggestive of a hypersensitivity pneumonitis-like pattern.
- Infection was ruled out by bronchoalveolar lavage fluid analysis and serological tests.
Findings:
- Hydroxycarbamide treatment was discontinued, coinciding with the resolution of thrombocytopenia and suspected hemolytic anemia.
- The patient showed rapid clinical and radiological improvement following the initiation of oxygen and steroid therapy.
- These findings indicate hydroxycarbamide-induced lung toxicity.
Implications:
- Physicians should be vigilant for potential pulmonary toxicity in patients receiving hydroxycarbamide.
- Prompt cessation of hydroxycarbamide and empiric corticosteroid treatment are crucial for managing this adverse effect.
- Awareness of hydroxycarbamide's lung toxicity is essential given its increasing use in diverse medical conditions.
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