[Hydroxyurea-induced pneumonitis]

Abstract

Background: Hydroxyurea (HU) is a good-controllable and well-tolerated cytostatic drug.

Case report: Two patients with a myeloproliferative disease, who suffered from fever, lung symptoms and reticulonodular infiltrates on both sides after 4 and 10 weeks of HU medication, are introduced. One patient additionally presented with multiple, 1-cm diameter, pustulous (central abscess-like), elevated, livid skin lesions on his forearms and shins. After discontinuance of the HU administration, symptoms vanished within 1-2 days, but could be reinduced by HU reexposition within hours.

Conclusion: Nine cases with a pneumonitis (alveolitis or interstitial lung disease) have been described so far. In all cases, including ours, HU medication was usually administered over a 3- to 12-week period, mostly for 4 weeks (five of eleven cases). All patients showed a uniform illness with fever (11/11), chills (6/11), reticular or nodular infiltrates on both sides (11/11), small pleural effusions (5/11), and lung symptoms (11/11) such as dyspnea (10/11) or cough (5/11). Due to the acute or subacute onset, all cases were first misinterpreted as bacterial pneumonia.