Chronic eosinophilic pneumonia after trastuzumab and radiation therapy for breast cancer: A case report

Medicine (Baltimore). 2019 Jan;98(1):e14017. doi: 10.1097/MD.0000000000014017.

Abstract

Rationale: Chronic eosinophilic pneumonia (CEP) is rare and an idiopathic disorder. The disease has been associated with drugs, infection, or irradiation, and its relationship with asthma remains unclear.

Patient concerns: We reported a case of a 49-year-old female patient after trastuzumab and radiation therapy for breast cancer. Two months after radiation treatment, the patient complained of productive cough, progressive breathlessness, occasional wheezing, and left pectoralgia.

Diagnoses: Computed tomography (CT) scan revealed infiltrates in lungs. Without evidence of infection, marked increased eosinophils in a transbronchial biopsy performed from the left upper lobe confirmed the diagnosis of CEP after trastuzumab and radiation therapy.

Interventions: The patient was started with oral prednisone at 0.5 mg/kg/day.

Outcomes: A CT scan of the chest obtained 2 weeks after steroid treatment showed diminishment of the lesions, and at the 6-month follow-up, the patient had no complaints of discomfort with no relapse of pulmonary lesions.

Lessons: Physicians should consider CEP as a diagnosis in patients who have had previous exposure to trastuzumab and radiation therapy, especially with a history of asthma. Timely diagnosis and treatment may benefit these patients.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / radiotherapy
  • Chronic Disease
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Middle Aged
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Pulmonary Eosinophilia / chemically induced*
  • Pulmonary Eosinophilia / diagnostic imaging
  • Pulmonary Eosinophilia / drug therapy
  • Pulmonary Eosinophilia / pathology
  • Radiotherapy / adverse effects*
  • Tomography, X-Ray Computed / methods
  • Trastuzumab / adverse effects*
  • Trastuzumab / therapeutic use
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological
  • Glucocorticoids
  • Trastuzumab
  • Prednisone