World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
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Case Report

Volume 5, Number 5-6, December 2014, pages 232-236

Pemetrexed-Induced Interstitial Pneumonitis: A Case Study and Literature Review

Figures

Figure 1.
Figure 1. High-resolution lung computed tomography before pemetrexed administration.
Figure 2.
Figure 2. Chest X-ray on initial presentation, showing diffuse bilateral reticulonodular opacities in the upper lobes.
Figure 3.
Figure 3. Lung computed tomography during acute illness, showing bilateral diffuse interstitial changes and ground-glass opacities.
Figure 4.
Figure 4. High-resolution lung computed tomography 1 month post-illness, showing interval resolution of interstitial changes.
Figure 5.
Figure 5. Further resolution on computed tomography, 4 months post-illness.

Table

Table 1. Reported Cases of Pemetrexed-Induced Pneumonitis
 
CaseNumber of cyclesTime of symptom onset after last dosePrior radiationBALBiopsy confirmationRechallengedOutcome
BAL: Bronchoalveolar lavage; CT: computed tomography; (-): information not available from case report.
Loriot et al 2009 [10]53 daysNoYesNoNoReturned to pre-morbid status. Signs of pulmonary fibrosis on CT.
Kim et al 2010 [11]4“Shortly after”NoNoYesNo“Slow improvement”.
Nagata et al 2010 [12]14 weeksNoNoNoNoDied 3 weeks after symptom onset.
Nagata et al 2010 [12]13 weeksNoNoNoNoDied 2 weeks after symptom onset.
Breuer and Nechushtan 2011 [13]4-NoNoNoYesPneumonitis recurred after rechallenge. Symptoms resolved in 2 weeks.
Hochstrasser et al 2012 [14]21 weekYesNoNoYesPemetrexed was continued. Patient died 5 days after next dose.
Hochstrasser et al 2012 [14]2-NoYesNoNoImproved rapidly; symptoms resolved.
Kim et al 2013 [15]13 weeksNoYesYesNoRecovered; commenced erlotinib.
Waters et al 2013213 daysYesNoNoNoImproved rapidly.