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Myocardial Infarction As the Initial Presentation of Rituximab-Induced Interstitial Lung Disease: A Case Report
Mohamed Mahmoud1, Arshan A Khan2, Khadija El Kortbi3
1Internal Medicine, University of Texas Health Science Center at San Antonio, San Antonio, USA.
Cureus
|September 23, 2022
Summary
Rituximab-induced interstitial lung disease (RTX-ILD) is a rare but potentially fatal complication. This case highlights RTX-ILD in a patient with mantle cell lymphoma, emphasizing diagnostic challenges and poor prognosis.
Area of Science:
- Oncology
- Pulmonology
- Immunology
Background:
- Rituximab is a monoclonal antibody used for B-cell malignancies and autoimmune diseases.
- Rituximab-induced interstitial lung disease (RTX-ILD) is a rare, potentially fatal adverse event.
- Early diagnosis and management of RTX-ILD are crucial.
Observation:
- A patient with stage 4 mantle cell lymphoma on rituximab presented with respiratory distress and myocardial infarction.
- Cardiac catheterization showed no obstructive coronary lesions or graft issues.
- Infectious and autoimmune workups were negative, except for Stenotrophomonas maltophilia pneumonia.
Findings:
- The patient was diagnosed with probable RTX-ILD after excluding other causes.
- Clinical improvement was not observed despite antibiotic and steroid treatments.
- The patient's condition did not improve, leading to discharge to a long-term acute care facility.
Implications:
- This case underscores the importance of considering RTX-ILD in patients on rituximab presenting with respiratory symptoms.
- Diagnostic challenges in RTX-ILD necessitate a high index of suspicion.
- The potentially fatal nature of RTX-ILD highlights the need for further research into early detection and effective treatment strategies.
Keywords:
acute hypoxemic respiratory failurechemotherapy-related toxicitydrug induced interstitial lung diseasesground-glass opacitiesinterstitial pneumonialymphomanon-st elevated myocardial infarctionpneumocystis jiroveci pneumoniarituximab therapystenotrophomonas maltophiliaMore Related Videos
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