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August 15, 1980

Rapidly Progressive, Fatal Pulmonary Fibrosis Induced by Carmustine

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