Int J Thyroidol.  2019 Nov;12(2):127-131. 10.11106/ijt.2019.12.2.127.

A Case of Severe Pneumocystis Pneumonia in a Thyroid Cancer Patient Receiving Lenvatinib

• Jin MH
• Kim WG
• Kim TY
• Kim WB
• Shong YK
• Jeon MJ

• KMID: 2465066
• DOI: http://doi.org/10.11106/ijt.2019.12.2.127

Abstract

Lenvatinib is a multitargeted tyrosine kinase inhibitor approved for use in patients with iodine-131-refractory thyroid cancer. The common adverse events of lenvatinib include hypertension, proteinuria, fatigue, and diarrhea. To date, no report on Pneumocystis pneumonia (PCP) in patients receiving lenvatinib has been published. Here, we present a case of severe PCP that led to the death of a 79-year-old woman who was diagnosed with poorly differentiated thyroid cancer and received lenvatinib. The development of PCP should be considered when patients taking lenvatinib show clinical symptoms of pneumonia, and regular chest X-ray follow-up is needed for patients receiving lenvatinib.

Keyword

Lenvatinib; Pneumocystis pneumonia; Interstitial pneumonia; Thyroid cancer

MeSH Terms

Aged
Diarrhea
Fatigue
Female
Follow-Up Studies
Humans
Hypertension
Lung Diseases, Interstitial
Pneumocystis*
Pneumonia
Pneumonia, Pneumocystis*
Protein-Tyrosine Kinases
Proteinuria
Thorax
Thyroid Gland*
Thyroid Neoplasms*
Protein-Tyrosine Kinases

Figure

• 

  Fig. 1 Initial chest X-rays before the patient receive lenvatinib showing no active lung lesion.

• 

  Fig. 2 Chest X-rays showing diffuse ground-glass opacities in the right lower lobe (A). Lateral view of the same-day X-ray image (B).

• 

  Fig. 3 Chest CT scan showing multifocal patchy groundglass opacities in both lungs at the time of admission (A–D).

• 

  Fig. 4 Chest X-ray analysis on day 3 of hospitalization, showing progression of ground-glass opacities in the right lung (A). Chest X-ray analysis on day 14 of hospitalization show ing diffuse bilateral lung opacities (B).

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