131I-labeled lipiodol-induced interstitial pneumonia

Abstract

Drug-induced interstitial pneumonia is a severe disease that has been reportedly caused by more than 100 compounds, the most common being amiodarone, methotrexate and bleomycin. We report a case of fatal acute interstitial pneumonia occurring after a second injection of ¹³¹I-labeled lipiodol for hepatocellular carcinoma treatment. Infectious pneumonia was ruled out and lung biopsy revealed a pattern of usual interstitial pneumonia. Despite early initiation of systemic corticosteroids and additionally, antioxidant medications, the patient’s condition gradually worsened and he died 24 days after admission. ¹³¹I-labeled lipiodol-induced interstitial pneumonia is probably frequently undiagnosed. A better knowledge of this disease would help to estimate its true incidence and may impact on the perceived risk/benefit ratio for its treatment. Moreover, this may have consequences on the prescription of ¹³¹I-labeled lipiodol.