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KMID : 0191120120270040450
Journal of Korean Medical Science
2012 Volume.27 No. 4 p.450 ~ p.453
Temozolomide-Associated Bronchiolitis Obliterans Organizing Pneumonia Successfully Treated with High-Dose Corticosteroid
Kim Tae-Ok

Oh In-Jae
Kang Hyun-Wook
Chi Su-Young
Ban Hee-Jung
Kwon Yong-Soo
Kim Kyu-Sik
Kim Yu-Il
Lim Sung-Chul
Kim Young-Chul
Abstract
Temozolomide is an oral alkylating agent with clinical activity against glioblastoma multiforme (GM). It is generally well-tolerated and has few pulmonary side effects. We report a case of temozolomide-associated brochiolitis obliterans organizing pneumonia (BOOP) requiring very high-dose corticosteroid treatment. A 56-yr-old woman presented with a 2-week history of exertional dyspnea. For the treatment of GM diagnosed 4 months previously, she had undergone surgery followed by chemoradiotherapy, and then planned adjuvant chemotherapy with temozolomide. After the 1st cycle, progressive dyspnea was gradually developed. Chest radiograph showed diffuse patchy peribronchovascular ground-glass opacities in both lungs. Conventional dose of methylprednisolone (1 mg/kg/day) was begun for the possibility of BOOP. Although transbronchial lung biopsy findings were compatible with BOOP, the patient's clinical course was more aggravated until hospital day 5. After the dose of methylprednisolone was increased (500 mg/day for 5 days) radiologic findings were improved dramatically.
KEYWORD
Bronchiolitis Obliterans Organizing Pneumonia (BOOP), Temozolomide, Methylprednisolone
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