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Vol. 38. Issue 10.
Pages 492-494 (October 2002)
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Vol. 38. Issue 10.
Pages 492-494 (October 2002)
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Toxicidad pulmonar por talidomida
Lung toxicity due to thalidomide
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10601
F. Carrión Valero
Servicios de Neumología Hospital Clínico Universitario. Facultad de Medicina. Universitat de València. Valencia
V. Bertomeu Gonzáleza
a Servicios de Cardiología. Hospital Clínico Universitario. Facultad de Medicina. Universitat de València. Valencia
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La talidomida es un fármaco bien conocido por sus efectos secundarios, aunque la toxicidad pulmonar no ha sido comunicada. Presentamos el caso de un varón de 65 años, diagnosticado de mieloma múltiple IgG kappa en estadio IA, que en el día 37 del tratamiento con talidomida presentó de forma aguda tos, malestar general, disnea de reposo y sudación. La presión arterial era 90/60mmHg y no tenía fie-bre. En la radiografía de tórax había un patrón intersticial alveolar en el hemitórax derecho, y en la gasometría arterial una insuficiencia respiratoria parcial (pH 7,40, PaCO240mmHg, PaO247mmHg). El análisis de sangre evidenció alteraciones propias de su mieloma múltiple y las determinaciones microbiológicas fueron negativas (esputo, hemocultivos y detección de antígenos de Streptococcus pneumoniae y Legionella pneumophilaen orina). Tras la retirada del fármaco y recibir oxigenoterapia y corticoides intravenosos, el paciente evolucionó bien. Una radiografía de tórax realizada 4 días después fue normal y en la gasometría arterial desa-pareció la insuficiencia respiratoria

Como conclusión, cabe mencionar que la toxicidad pulmonar grave deberá ser incluida entre los efectos adversos potenciales de la talidomida

Palabras clave:
Talidomida
Toxicidad pulmonar
Mieloma múl-tiple

Although the side effects of thalidomide are well known, lung toxicity has not been reported. We describe the case of a 65-year-old man with multiple myeloma (IgG kappa) in stage IA who, on the thirty-seventh day of treatment with thalidomide, developed acute coughing, general malaise, dyspnea at rest and sudoresis. Blood pressure was 90/60mm Hg and temperature was normal. An interstitial and alveolar pattern was visible on the right side of a chest film and arterial blood gases indicated partial respiratory insufficiency (pH 7.40, PaCO,240mmHg, PaO247mmHg). Blood analysis showed alterations expected for multiple myeloma and microbiology was negative (sputum and blood cultures and urinary antigen detection for Streptococcus pneumoniae and Legionella pneumophila). After thalidomide was withdrawn and oxygen and intravenous corticoids were administered, outcome was good. A chest film 4 days later was normal and arterial blood gases showed that respiratory insufficiency had disappeared

We conclude that severe lung toxicity should be included among the potential adverse effects of thalidomide

Keywords:
Thalidomide
Lung toxicity
Multiple myeloma
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