Vedolizumab-associate diffuse interstitial lung disease in patients with ulcerative colitis: A case report

Abstract

BACKGROUND,Vedolizumab, a newer class of integrin antagonist biological agents, has been,applied to treat patients with moderate-to-severe Crohn’s disease (CD) and,ulcerative colitis (UC), especially for patients who are refractory to traditional,therapies and tumor necrosis factor antagonists. However, some rare but life-threatening adverse effects warrant pharmacovigilance. We describe the first fatal,case of vedolizumab-associated severe diffuse interstitial lung disease in China.,CASE SUMMARY,We present a case of new-onset diffuse parenchymal lung disease developing,under treatment with vedolizumab in a patient with UC. After two doses of,vedolizumab, he developed persistent fever and progressively worsening,dyspnea. Extensive workups, including bronchoalveolar lavage, transbronchial,lung biopsy and metagenomic next-generation sequencing, identified no,infectious causes, and other potential causes (such as tumors and cardiogenic,pulmonary edema) were also excluded. As a result, a diagnosis of vedolizumabrelated interstitial lung disease was established. Unfortunately, although corticost-eroids and empiric antibiotics were administered, the patient eventually died of,respiratory failure.,CONCLUSION,Vedolizumab-related interstitial lung disease in patients with UC is rare but,potentially lethal. Gastroenterologists and pulmonologists should be aware of,vedolizumab-related adverse drug reactions.