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Bleomycin Hypersensitivity Pneumonitis

PAUL Y. HOLOYE, M.D.; MARIO A. LUNA, M.D.; BRUCE MacKAY, M.D.; and CARLOS W. M. BEDROSSIAN, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Carlos W.M. Bedrossian, M.D.; Department of Pathology and Laboratory Medicine, The University of Texas Medical School, P.O. Box 20708; Houston, TX 77030.


Houston, Texas


© 1978 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1978;88(1):47-49. doi:10.7326/0003-4819-88-1-47
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Three patients developed radiologic and functional pulmonary changes after bleomycin therapy similar to ones previously associated with administration of this drug. However, biopsy specimens showed a pattern consistent with hypersensitivity pneumonitis rather than the interstitial pneumonia usually reported in bleomycin pulmonary toxicity. There was a patchy eosinophilic infiltrate surrounding small airways and distal air spaces, but no immune deposits were noted by ultrastructure or immunofluorescence using conventional techniques and a specific antibody against bleomycin. Two of the patients had peripheral eosinophilia of 12% and 16%. All three patients showed considerable improvement on chest roentgenogram after corticosteroid treatment. Our findings are consistent with the view that bleomycin hypersensitivity pneumonitis has a different pathogenesis than bleomycin interstitial pneumonitis. Its recognition as a separate entity seems warranted because of the favorable response to steroid therapy.

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