UNASSIGNED: A 57-year-old Thai woman diagnosed with stage II right breast cancer. She received adjuvant chemotherapy comprising doxorubicin and cyclophosphamide, followed by weekly paclitaxel. After the ninth paclitaxel cycle, she developed acute respiratory failure. Transbronchial biopsies revealed acute fibrinous and organizing pneumonitis. The patient was placed in prone position. Following the administration of dexamethasone, her symptoms improved. However, while reducing the dexamethasone dosage, she developed new-onset dyspnea as well as Takotsubo cardiomyopathy. Intravenous methylprednisolone 500 mg/day was administered for 3 days followed by transition to intravenous dexamethasone and slow tapering to prednisolone. Prednisolone was gradually tapered and eventually discontinued after 3 months.
UNASSIGNED: Paclitaxel-induced pneumonitis is a rare complication. The diagnosis should be considered in any patient who develops respiratory symptoms while receiving paclitaxel. Acute fibrinous and organizing pneumonitis is a rare type of interstitial pneumonitis with high recurrence and mortality rates. High-dose steroids are needed to treat this type of pneumonitis.
■一名57岁的泰国妇女被诊断患有II期右乳腺癌。她接受了包括阿霉素和环磷酰胺的辅助化疗,其次是每周紫杉醇。第9个紫杉醇周期后,她出现了急性呼吸衰竭。经支气管活检显示急性纤维性和组织性肺炎。患者处于俯卧位。在给予地塞米松后,她的症状有所改善。然而,在减少地塞米松剂量的同时,她出现了新发作的呼吸困难和Takotsubo心肌病。静脉注射甲基强的松龙500mg/天,持续3天,然后过渡到静脉注射地塞米松,并缓慢逐渐减少到强的松龙。泼尼松龙逐渐变细,最终在3个月后停用。
■紫杉醇诱导的肺炎是一种罕见的并发症。在接受紫杉醇时出现呼吸道症状的任何患者都应考虑诊断。急性纤维性和组织性肺炎是一种罕见的间质性肺炎,复发率和死亡率高。需要大剂量类固醇来治疗这种类型的肺炎。