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In distinction from acute inflammation, there are typically fewer neutrophils seen in chronic lesions and there is more involvement of portal areas with infiltrating mononuclear cells and disruption of limiting plates

Withhold pemetrexed for acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, or fever pending diagnostic evaluation

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doi: 10.1002/bms.1200110508

Rare but serious side effects include pancreatitis, diabetic retinopathy, thyroid tumors, and kidney damage