Drug-induced interstitial lung disease associated with dasatinib coinciding with active tuberculosis.
Nozomi TaniYusuke KunimatsuIzumi SatoYuri OguraKazuki HiroseTakayuki TakedaPublished in: Respirology case reports (2020)
A 69-year-old woman was diagnosed with a breakpoint cluster region-Abelson-positive chronic myeloid leukaemia and treated with dasatinib for 14 months. She presented with one month of high-grade fever and persistent dry cough. Chest computed tomography revealed non-segmental subpleural consolidation, ground-glass opacities, and interlobular septal thickening. The bronchoalveolar lavage (BAL) and transbronchial lung biopsy confirmed a diagnosis of drug-induced interstitial lung disease (ILD) associated with dasatinib. Then, systemic corticosteroid treatment was initiated, which was effective and the interstitial shadow disappeared after two weeks. The acid-fast bacilli culture test of BAL fluid after three weeks was positive for Mycobacterium tuberculosis, and combination therapy with four antituberculosis drugs was added. It is known that drug-induced ILD and susceptibility to infection associated with dasatinib occur in a dose-dependent manner. This is the first case of dasatinib-induced ILD which coincided with active tuberculosis.
Keyphrases
- drug induced
- interstitial lung disease
- liver injury
- systemic sclerosis
- mycobacterium tuberculosis
- combination therapy
- chronic myeloid leukemia
- rheumatoid arthritis
- idiopathic pulmonary fibrosis
- computed tomography
- high grade
- adverse drug
- pulmonary tuberculosis
- ultrasound guided
- bone marrow
- low grade
- acute myeloid leukemia
- positron emission tomography
- magnetic resonance imaging
- hiv aids
- gestational age
- heart failure
- magnetic resonance
- endothelial cells
- multidrug resistant
- left ventricular
- antiretroviral therapy
- emergency department
- oxidative stress
- preterm birth
- hypertrophic cardiomyopathy
- image quality