Document Detail

Pathogenesis of pulmonary edema during interleukin-2 therapy: correlation of chest radiographic and clinical findings in 54 patients.
MedLine Citation:
PMID:  1898799     Owner:  NLM     Status:  MEDLINE    
The pathogenesis of pulmonary edema that occurs during interleukin-2 therapy has often been attributed to an increase in pulmonary capillary permeability. However, renal insufficiency, fluid overload, and hypotension also develop in many patients. These manifestations of systemic toxicity may contribute to the development of pulmonary edema during therapy. Understanding the cause of pulmonary edema during interleukin-2 therapy could directly affect patients' care. Therefore, we reviewed the chest radiographs and clinical course of 54 patients who received high-dose interleukin-2 therapy and lymphokine-activated killer cells for advanced carcinoma. The type, frequency, and course over time of pulmonary abnormalities were recorded and correlated with clinical measures of renal function, fluid status, and blood pressure. Focal or diffuse parenchymal lung opacities were found on radiographs in 43 (80%) of 54 patients. Findings of interstitial pulmonary edema were most common, occurring in 76% of patients. Weight gain, hypotension, and elevation of the serum creatinine level were not associated statistically with interstitial edema. Diffuse air-space disease developed in 20% of patients. Focal consolidation, which was associated with positive central venous catheter cultures (p less than .03), developed in 28% of patients. Pleural effusion occurred in 48% of patients and was associated with all types of parenchymal disease. These data suggest that the frequent development of pulmonary edema during interleukin-2 therapy is not due to renal insufficiency, fluid overload, or hypotension, but is more likely the result of an interleukin-2-related increase in pulmonary capillary permeability.
R R Saxon; J S Klein; M H Bar; P Blanc; G Gamsu; W R Webb; F R Aronson
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  156     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  1991 Feb 
Date Detail:
Created Date:  1991-02-14     Completed Date:  1991-02-14     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  281-5     Citation Subset:  AIM; IM    
Department of Radiology, University of California, San Francisco, School of Medicine 94143-0628.
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MeSH Terms
Carcinoma, Renal Cell / drug therapy,  epidemiology,  radiography
Interleukin-2 / adverse effects*,  pharmacokinetics
Kidney Neoplasms / drug therapy,  epidemiology,  radiography
Melanoma / drug therapy,  epidemiology,  radiography
Middle Aged
Neoplasms / drug therapy*,  epidemiology,  radiography
Pulmonary Edema / chemically induced*,  epidemiology,  radiography
Radiography, Thoracic
Retrospective Studies
Grant Support
Reg. No./Substance:

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