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August 15, 1980

Rapidly Progressive, Fatal Pulmonary Fibrosis Induced by Carmustine

Author Affiliations

From the Pulmonary Disease Division, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.

JAMA. 1980;244(7):687-688. doi:10.1001/jama.1980.03310070037025

CARMUSTINE (BCNU), one of a new class of anticancer drugs, is employed in the combination treatment of several malignant conditions and as a single agent in the treatment of CNS malignant diseases.1,2 There have been several reports of pulmonary toxicity in drug regimens including carmustine,3,4 but only a few cases where carmustine was the only cytotoxic drug employed.1,5 There have been no reported instances, to our knowledge, of carmustine toxicity occurring after a low dose of carmustine alone, after a short latent interval, and occurring as the adult respiratory distress syndrome (ARDS). We report here a case of rapidly progressive fatal pulmonary fibrosis, presenting as ARDS, in a patient who received a short course of carmustine as the sole antineoplastic agent.

Report of a Case  A 54-year-old woman noticed fatigue and left arm weakness, followed by a grand mal seizure in August 1978. In November, left arm