Successful steroid pulse therapy for COVID-19 associated respiratory failure initially mimicking bortezomib-induced lung injury

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  • 薬剤性肺障害との鑑別に苦慮するもステロイドパルス療法が奏効したCOVID-19関連肺炎併発多発性骨髄腫
  • ヤクザイセイ ハイ ショウガイ ト ノ カンベツ ニ クリョ スル モ ステロイドパルス リョウホウ ガ ソウコウ シタ COVID-19 カンレン ハイエン ヘイハツ タハツセイ コツズイシュ

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Abstract

<p>From December 2019, a 71-year-old male underwent three cycles of a combination therapy of pomalidomide, bortezomib, and dexamethasone for relapsed multiple myeloma and a very good partial response was achieved. In March 2020, he developed a fever of 38.9°C and computed tomography revealed bilateral ground-glass opacities. Antibiotic therapy was ineffective. Bronchoscopy was performed and bortezomib-induced lung injury was initially suspected. Due to respiratory exacerbation, high-dose steroid therapy was administered, which resulted in a dramatic improvement of the patient’s respiratory failure. Thereafter, reverse transcription polymerase chain reaction performed on a preserved bronchial lavage sample tested positive, and thus his diagnosis was corrected to COVID-19 pneumonia. It is difficult to discriminate COVID-19 pneumonia from drug-induced lung disease, as both disorders can present similar ground-glass opacities on computed tomography. Therefore, with this presented case, we summarize our experience with steroid therapy for COVID-19 associated respiratory distress at our institution.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 62 (1), 30-34, 2021

    The Japanese Society of Hematology

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