Drug‐induced interstitial lung disease associated with dasatinib coinciding with active tuberculosis

Abstract

Abstract A 69‐year‐old woman was diagnosed with a breakpoint cluster region‐Abelson‐positive chronic myeloid leukaemia and treated with dasatinib for 14 months. She presented with one month of high‐grade fever and persistent dry cough. Chest computed tomography revealed non‐segmental subpleural consolidation, ground‐glass opacities, and interlobular septal thickening. The bronchoalveolar lavage (BAL) and transbronchial lung biopsy confirmed a diagnosis of drug‐induced interstitial lung disease (ILD) associated with dasatinib. Then, systemic corticosteroid treatment was initiated, which was effective and the interstitial shadow disappeared after two weeks. The acid‐fast bacilli culture test of BAL fluid after three weeks was positive for Mycobacterium tuberculosis, and combination therapy with four antituberculosis drugs was added. It is known that drug‐induced ILD and susceptibility to infection associated with dasatinib occur in a dose‐dependent manner. This is the first case of dasatinib‐induced ILD which coincided with active tuberculosis.

Keywords

• Chronic myeloid leukaemia
• dasatinib
• drug‐induced interstitial lung disease
• tuberculosis
• tyrosine kinase inhibitor