Tsurui T, Mura E, Horiike A, Tsunoda T. Oxaliplatin-induced diffuse alveolar hemorrhage: A case report. World J Clin Oncol 2025; 16(4): 105077 [DOI: 10.5306/wjco.v16.i4.105077]
Corresponding Author of This Article
Toshiaki Tsurui, MD, Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 1428555, Tōkyō, Japan. t.tsurui@med.showa-u.ac.jp
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Toshiaki Tsurui, Emiko Mura, Atsushi Horiike, Takuya Tsunoda, Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo 1428555, Tōkyō, Japan
Author contributions: Tsurui T conceptualized the study and drafted the manuscript; Mura E coordinated the study; Mura E, Horiike A, and Tsunoda T revised the manuscript; and all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshiaki Tsurui, MD, Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 1428555, Tōkyō, Japan. t.tsurui@med.showa-u.ac.jp
Received: January 11, 2025 Revised: February 4, 2025 Accepted: February 27, 2025 Published online: April 24, 2025 Processing time: 75 Days and 1.1 Hours
Abstract
BACKGROUND
Drug-induced lung injury is a common adverse effect of chemotherapeutic agents. Diffuse alveolar hemorrhage (DAH) is a fatal complication associated with drug-induced lung injury. Early diagnosis and treatment of DAH is critical, as delayed management can lead to respiratory failure and poor outcomes. However, the diagnosis of DAH is difficult because of the nonspecific clinical manifestations; as such, bronchoscopy is necessary to establish a diagnosis.
CASE SUMMARY
The patient presented with fever and dry cough. He had been receiving fluoropyrimidine and oxaliplatin therapy for esophageal squamous cell carcinoma. Chest imaging revealed diffuse ground-glass opacities. Bronchoscopy with bronchoalveolar lavage was performed, which confirmed the diagnosis of DAH. Although the patient’s respiratory status rapidly worsened, high-dose corticosteroid therapy with respiratory support gradually improved the patient’s condition and he was successfully extubated.
CONCLUSION
Prompt DAH diagnosis and bronchoscopy in patients receiving oxaliplatin-containing chemotherapy presenting with acute respiratory failure are critical for improving outcomes.
Core Tip: This report describes a case of a serious complication of oxaliplatin-induced diffuse alveolar hemorrhage. The diagnosis of diffuse alveolar hemorrhage (DAH) is challenging because the clinical manifestations and radiographic findings of DAH, such as diffuse bilateral opacities, are non-specific, necessitating bronchoscopy with bronchoalveolar lavage fluid analysis to establish the diagnosis of DAH. As early diagnosis by bronchoscopy and prompt initiation of corticosteroid treatment were essential for saving the patient, clinicians should be aware that diffuse alveolar hemorrhage is a potential cause of respiratory failure in patients receiving oxaliplatin.
