Vol. 21 No. 1 (2023)
Case Report

A Case of Organizing Pneumonia Following Azacitidine Treatment for Myelodysplastic Syndrome

Kelly Ann Hutchinson
McGill University
Carole-Ann Hébert
McGill University
Ajay Rajaram
McGill University
Pierre-Olivier Fiset
McGill University
Kevin Schwartzman
McGill University
X-ray image of the chest of a person

Published 2023-05-10

Keywords

  • organizing pneumonia, myelodysplastic syndrome, azacitidine

How to Cite

1.
Hutchinson KA, Hébert C-A, Rajaram A, Fiset P-O, Schwartzman K. A Case of Organizing Pneumonia Following Azacitidine Treatment for Myelodysplastic Syndrome. McGill J Med [Internet]. 2023 May 10 [cited 2025 Oct. 6];21(1). Available from: https://mjm.mcgill.ca/article/view/983

Abstract

Organizing pneumonia (OP) is a lung pathology mainly affecting distal lung structures. Its etiology is often unknown, in which case it is termed cryptogenic organizing pneumonia (COP).  Of those cases of OP with an identified cause, the usual culprits include infections, medications, and radiation therapy. In this report, we present the case of a 73-year-old female on azacitidine –a pyrimidine analogue– used for treatment of myelodysplastic syndrome (MDS). The patient presented with fever, productive cough, and pleuritic chest pain. A CT of the chest, a bronchoalveolar lavage and a transthoracic biopsy were performed, and findings were consistent with OP, thought to be induced by azacitidine. The patient was treated with prednisone and subsequently showed significant improvement. Although rare, this case underlines the importance of considering OP in the context of non-resolving pulmonary infiltrates, particularly when there is a potentially relevant exposure, such as azacitidine.

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