Acute respiratory failure after interferon-γ therapy of end-stage pulmonary fibrosis

Interferon (IFN)-gamma was recently proposed as a treatment for idiopathic pulmonary fibrosis. We report on four patients who developed acute respiratory failure with new alveolar opacities after 2 (two patients), 6, and 35 injections of IFN-gamma-1b. All four patients had advanced idiopathic pulmon...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2003-04, Vol.167 (7), p.953-957
Main Authors: HONORE, Isabelle, NUNES, Hilario, GROUSSARD, Odile, KAMBOUCHNER, Marianne, CHAMBELLAN, Arnaud, AUBIER, Michel, VALEYRE, Dominique, CRESTANI, Bruno
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Biological and medical sciences
Dose-Response Relationship, Drug
Drug toxicity and drugs side effects treatment
Glucocorticoids - administration & dosage
Glucocorticoids - adverse effects
Humans
Interferon-gamma - administration & dosage
Interferon-gamma - adverse effects
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Pulmonary Fibrosis - complications
Pulmonary Fibrosis - drug therapy
Respiratory Insufficiency - chemically induced
Toxicity: respiratory system, ent, stomatology
Treatment Failure
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Summary:Interferon (IFN)-gamma was recently proposed as a treatment for idiopathic pulmonary fibrosis. We report on four patients who developed acute respiratory failure with new alveolar opacities after 2 (two patients), 6, and 35 injections of IFN-gamma-1b. All four patients had advanced idiopathic pulmonary fibrosis (total lung capacity less than 45% predicted or carbon monoxide diffusion capacity less than 30% predicted), and two patients had familial pulmonary fibrosis. No other cause of deterioration was found. Refractory hypoxemia led to death in three cases and to lung transplantation in one case. Pathologic studies in two patients showed diffuse alveolar damage lesions with preexisting usual interstitial pneumonia. These cases suggest that IFN-gamma therapy can induce an acute respiratory failure in patients with end-stage idiopathic pulmonary fibrosis.
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.200208-818CR