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A Rare Case of Gemcitabine-Induced Pulmonary Hypertension
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Abstract [+]
Context
Gemcitabine is the backbone of systemic treatment of locally advanced and metastatic intrahepatic cholangiocarcinoma. In recent literature, gemcitabine has been linked to various pulmonary side effects.
Case Report
We report a case of an 82-year-old male who developed acute pulmonary hypertension after receiving one cycle of gemcitabine for metastatic cholangiocarcinoma. His symptoms began with fatigue associated with shortness of breath and cough that worsened despite dose reduction. He developed new onset bilateral pulmonary effusions and an echocardiogram revealed findings consistent with pulmonary hypertension. A computed tomography (CT) angiogram was negative for pulmonary thromboembolism. Although he was promptly treated with diuretics and steroids, the patient could not tolerate any further therapy.
Conclusion
Gemcitabine-induced pulmonary hypertension is rare and can be challenging to diagnose, as it remains a diagnosis of exclusion. However, physicians should be vigilant of new pulmonary symptoms, as delayed treatment can cause significant patient morbidity and mortality.
Keywords
Cholangiocarcinoma; Gemcitabine; Pulmonary hypertension.
Abbreviations
CT: Computed Tomography; PE: Pulmonary Thromboembolism; GIPT: Gemcitabine-Induced Pulmonary Toxicity.
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Editor-in-Chief
Masahiro Kohzuki, MD, PhD
Associate Dean Professor and Chairman Department of Internal Medicine and Rehabilitation Science, Disability Sciences Tohoku University Graduate School of Medicine Chairman of the Center of Rehabilitation Medicine Tohoku University Hospital Japan
Associate Editors
Zhaolin Xu, MD, FRCPC, FCAP
Professor, Dept. of Pathology, Dalhousie University Pulmonary Pathologist and Cytopathologist, QE II Health Sciences Centre Senior Scientist, Beatrice Hunter Cancer Research Institute 5788 University Ave Halifax NS B3H 1V8, Canada
Rasha Daabis, MD
Associate Professor of Chest Diseases Faculty of Medicine Alexandria University Egypt
Takeshi Saraya, MD, PhD
Assistant Professor Department of Respiratory Medicine Kyorin University School of Medicine Mitaka City, Tokyo, Japan