Adult respiratory distress syndrome in patients with malignant astrocytoma -Three case reports-

Toshihiro Kumabe, Teiji Tominaga, Takashi Yoshimoto, Takamasa Kayama

Research output: Contribution to journalArticlepeer-review


Three patients treated for intracranial malignant astrocytomas developed adult respiratory distress syndrome (ARDS). All three patients had a Karnofsky performance status score of at least 80% and similar clinical characteristics. All demonstrated hypersensitivity to phenytoin. ARDS occurred in two patients during radiotherapy and in one with radiation- induced brain damage following initial radiochemotherapy. ARDS occurred shortly after tapering the long-term administration of betamethasone. The initial symptoms were dry cough, fever, and generalized toxic eruption. Serum lactic acid dehydrogenase (LDH) concentrations were increased up to 2500 IU/I. Several days later, the patients suddenly complained of dyspnea. All patients fulfilled the diagnostic criteria for ARDS. Two patients recovered, but a young woman died. Clinical symptoms such as fever of unknown origin, dry cough, and skin eruptions, accompanied by abnormally increased serum LDH concentrations during or following the tapering of long-term administration of corticosteroids, are warning signs of ARDS in patients being treated for malignant gliomas.

Original languageEnglish
Pages (from-to)560-565
Number of pages6
JournalNeurologia Medico-Chirurgica
Issue number7
Publication statusPublished - 1997 Jul


  • Adult respiratory distress syndrome
  • Cytokine
  • Glioma
  • Phenytoin
  • Steroids


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