Talha Müezzinoglu, Arzu Yorgancıoğlu, Tuğba Göktalay, Ayşın Şakar Coşkun, Yavuz Havlucu, Pınar Çelik, Fikret Kurhan

GEMSİTABİNE BAĞLI GELİŞEN NADİR PULMONER TOKSİSİTE: BOOP

Gemsitabin bir primidin antimetabolitidir, küçük hücreli dışı akciğer karsinomu, pankreas, meme, ürogenital malignitelerde artan sıklıkta kullanılan, iyi tolere edilen bir kemoteropatiktir. En önemli doz kısıtlayıcı toksisitesi myelosupresyondur. Gemsitabin kullanımına bağlı gelişen pulmoner toksisiteler bronkospazm, Acute Respiratory Distress Syndrome (ARDS), plevral effüzyon ve interstisyel pnömonidir. Mesane karsinomu nedeniyle 5 kür sisplatin-gemsitabin kemoterapisi alan erkek hastada nefes darlığı, ateş ve öksürük yakınmaları ortaya çıkması, toraks bilgisayarlı tomografisinde (BT) periferik ağırlıklı, yamalı tarzda konsolidasyon alanları görülmesi, antibiyotik tedavisiyle yanıt alınamaması, olası dispne nedenleri dışlanması sonucunda klinik ve radyolojik olarak bronşiolitis obliterans organize pnömonisi (BOOP) düşünülmüş ve kortikosteroid tedavisi ile belirgin düzelme sağlanmıştır. Tanı ve tedavide gecikme fatal sonuçlara yol açabileceği için gemsitabin kullanımına bağlı pulmoner toksisite olarak BOOP gelişebileceği de akılda tutulmalıdır

Anahtar Kelimeler:

Gemsitabine, Pulmoner Toksisite, BOOP

RARE PULMONARY TOXICITY DUE TO GEMCITABINE: BOOP

Gemcitabine is a primidine antimetabolite, a well tolerated chemotheropathic used in non-small cell lung carcinoma, pancreas, breast, urogenital malignancies. The most important dose-limiting toxicity is myelosuppression. Pulmonary toxicities due to gemcitabine use are bronchospasm, Acute Respiratory Distress Syndrome (ARDS), pleural effusion and interstitial pneumonia. Complaints of shortness of breath, fever and cough occurred in a male patient who received 5 cycles of cisplatin-gemcitabine chemotherapy for bladder carcinoma. There was no response to antibiotic treatment in the patient, who had mainly peripheral, patchy consolidation areas on thorax computed tomography. In the patient whose other causes of dyspnea were excluded, bronchiolitis obliterans organizing pneumonia (BOOP) was considered clinically and radiologically, and significant improvement was achieved with corticosteroid therapy. It should be kept in mind that BOOP may develop as pulmonary toxicity due to gemcitabine use, as delay in diagnosis and treatment may lead to fatal results.

Keywords:

Gemcitabine, Pulmonary toxicity, BOOP,

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