Successful Crizotinib Rechallenge after Crizotinib-Induced Organizing Pneumonia in Anaplastic Lymphoma Kinase-Rearranged Non-Small Cell Lung Cancer

Crizotinib, a first-line anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor, has shown promising results for the treatment of locally advanced and metastatic lung cancer presenting the ALK rearrangement. On the other hand, secondary organizing pneumonia (OP) caused by anti-cancer drugs has been reported. While it is sometimes needed to rechallenge the suspected drug, the standard therapeutic strategy for secondary OP has not yet been established. We report a 60-year-old male with ALK-rearranged non-small cell lung cancer who developed crizotinib-induced OP and was successfully rechallenged with crizotinib. Six months after the rechallenge, the patient has achieved a partial response. To our knowledge, this is the first case in which crizotinib-induced OP has been successfully treated

Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma

A 66-year-old woman receiving continuous ambulatory peritoneal dialysis developed acute respiratory distress 12 hours after a fall. Blood gas analysis revealed hypoxia (PaO 2 67.7 torr) and metabolic acidosis with an increased anion gap, consistent with lactic acidosis (lactate, 86.5 mg/dL; normal range, 4.0–16.0). Magnetic resonance imaging showed a lumbar vertebral body fracture. On the fourth hospital day, the patient died of multiorgan failure and disseminated intravascular coagulation. Postmortem studies revealed fat emboli in the systemic circulation, ie, fat embolism syndrome. Diagnosing fat embolism syndrome can be difficult in patients on dialysis or in those with collagen vascular or pulmonary diseases