Delayed onset bleomycin-induced pneumonitis.

We describe a 39-year-old male patient who developed bleomycin-induced pneumonitis 2 years after completion of chemotherapy for nonseminomatous testicular cancer. Bleomycin sometimes causes fatal pulmonary toxicity, including bleomycin-induced pneumonitis. The central event in the development of pneumonitis is endothelial damage of the lung vasculature due to bleomycin-induced cytokines and free radicals. Pulmonary toxicity usually begins at bleomycin administration. The development of bleomycin-induced pneumonitis up to 6 months after bleomycin therapy has also been reported. We report a patient who developed bleomycin-induced pneumonitis 2 years after the initiation of bleomycin-containing chemotherapy regimens.

Intrathecal methotrexate-induced acute cerebellar syndrome.

Intrathecal application of chemotherapeutics has been the mainstay of central nervous system prophylaxis in acute lymphoblastic leukemia treatment. We describe a patient who developed acute cerebellar syndrome after prophylactic intrathecal methotrexate administration and recovered spontaneously. To our knowledge, this is the first case of methotrexate-related acute cerebellar syndrome.

Acute renal failure due to carnitine palmitoyltransferase II deficiency.

Carnitine palmitoyltransferase II (CPT-II) deficiency is the most common long-chain fatty acid oxidation defect, resulting in rhabdomyolysis and acute renal failure (ARF). There are three forms of CPT-II deficiency: the neonatal, infantile and adult form. We report an adult form of CPT-II deficiency in a patient who presented with attacks of exercise-induced rhabdomyolysis and ARF.