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Abstract
PURPOSE OF REVIEW Drug-induced vasculitis (DIV) is a rare form of vasculitis related to the use of various drugs. DIV primarily affects small to medium size vessels, but it can potentially involve vessels of any size. Differentiating between primary systemic vasculitis and DIV can be challenging; however, it is crucial, so that the offending agent can be discontinued promptly. RECENT FINDINGS The clinical phenotype of DIV is protean and depends on the size of the affected vessels. It ranges from arthralgias, to an isolated cutaneous rash, to severe single or multi-organ involvement. While withdrawal of the offending drug is the most important step in management, a significant number of patients require immunosuppressive therapy for varying periods of time. DIV can affect any vascular bed size, leading to protean vasculitic syndromes. Increased awareness among general practitioners, specialty, and subspecialty physicians is crucial for early recognition, and withdrawal of drug for better outcomes.
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Hoshina H, Takei H. Granulocyte-colony stimulating factor-associated aortitis in cancer: A systematic literature review. Cancer Treat Res Commun 2021; 29:100454. [PMID: 34530312 DOI: 10.1016/j.ctarc.2021.100454] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/19/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Aortitis following granulocyte-colony stimulating factor (G-CSF) administration has been reported in 0.3-0.47% of cases. To evaluate the characteristics of G-CSF-associated aortitis, we systematically reviewed the literature. METHODS We searched PubMed and found 49 cases of G-CSF-associated aortitis and cancer comorbidities and analyzed their characteristics and treatments. RESULTS Since 2004, cases of G-CSF-associated aortitis have been increasing, particularly in Asia (75.5%). The mean age was 60.1 years; 79.6% of patients were 50 years and older; and most patients were females (91.8%). All patients underwent chemotherapy (taxane, 51.0%). The most frequent symptom was fever, which occurred within 10 days (61.2%) of G-CSF administration, similar to that in febrile neutropenia. The period to remission was within 14 days in 44.9% of cases. Steroids were administered to 59.2% of patients; however, treatment efficacy was not significant. No patients died. CONCLUSIONS High levels of inflammatory cytokines might induce aortitis; however, further studies are warranted.
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Affiliation(s)
- Hideko Hoshina
- Department of Breast Surgery, Kikuna Memorial Hospital, 4-4-27 Kikuna, Kouhoku, Yokohama 222-0011, Kanagawa, Japan; Department of Breast Surgery and Oncology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo 113-8603, Japan.
| | - Hiroyuki Takei
- Department of Breast Surgery and Oncology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo 113-8603, Japan
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The incidence and clinical features of PEGylated filgrastim-induced acute aortitis in patients with breast cancer. Sci Rep 2020; 10:18647. [PMID: 33122662 PMCID: PMC7596224 DOI: 10.1038/s41598-020-75620-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/16/2020] [Indexed: 01/13/2023] Open
Abstract
Although PEGylated filgrastim-induced aortitis is very rare and unknown clinically, some cases were reported and increasing, especially in breast cancer patients. The present study investigated the prevalence, clinical features and treatment of aortitis induced by PEGylated filgrastim in patients with breast cancer. A total of 2068 consecutive patients who underwent neoadjuvant/adjuvant chemotherapy with PEGylated filgrastim for breast cancer were enrolled. From the medical record, clinical, laboratory, medication, and imaging evaluation findings were collected. PEGylated filgrastim-induced aortitis was established in 0.3% of the study population. Common clinical presentations included extremely high fever and chest/back pain with high levels of inflammatory markers without any signs of infection. Contrast-enhanced computed tomography scans revealed typical enhancing wall thickening and periaortic soft tissue infiltration at various levels of aorta. All patients improved rapidly after treatment with modest doses of prednisolone (0.5 mg/kg/day) without any complications. Clinicians should be aware of aortitis as a possible complication of granulocyte-colony stimulating factor therapy, especially PEGylated filgrastim, given the frequent misdiagnoses in neutropenic patients undergoing chemotherapy.
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Mukai T, Kubo S, Morita Y, Yamamoto M, Ikeda M. Aortitis which developed after the administration of granulocyte-colony stimulating factor. Mod Rheumatol Case Rep 2020; 4:74-78. [PMID: 33086976 DOI: 10.1080/24725625.2019.1629570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Drug-induced aortitis is rare; thus, the diagnosis of drug-induced aortitis could be delayed unless clinicians are aware of the disease entity. Herein, we describe the case of a 66-year-old woman who developed aortitis after administration of granulocyte-colony stimulating factor (G-CSF) during chemotherapy for her breast cancer. Thickening of the aortic wall was clearly detected by computed tomography (CT) and magnetic resonance imaging. After excluding the other possible aetiologies, an association between G-CSF and the development of aortitis was highly suspected. Corticosteroid treatment rapidly regressed the aortitis, as confirmed by follow-up CT examination. G-CSF analog is generally well tolerated; however, there are limited case reports of G-CSF-associated aortitis, suggesting the causative effect of G-CSF in the development of aortitis. Currently, G-CSF-associated aortitis has received little attention among rheumatologists. As the delayed diagnosis results in irreversible changes in the aorta, not only oncologists but also rheumatologists should be aware of this unrecognized disease entity, G-CSF-associated aortitis.
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Affiliation(s)
- Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan.,Department of Internal Medicine (Rheumatology), Fukuyama City Hospital, Fukuyama, Japan
| | - Shinichiro Kubo
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Mari Yamamoto
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - Masahiko Ikeda
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, Fukuyama, Japan
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Taimen K, Heino S, Kohonen I, Relas H, Huovinen R, Hänninen A, Pirilä L. Granulocyte colony-stimulating factor- and chemotherapy-induced large-vessel vasculitis: six patient cases and a systematic literature review. Rheumatol Adv Pract 2020; 4:rkaa004. [PMID: 32128475 PMCID: PMC7046168 DOI: 10.1093/rap/rkaa004] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/18/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Patients receiving chemotherapy are prone to neutropoenic infections, presenting with non-specific symptoms such as a high fever and elevated inflammatory parameters. Large-vessel vasculitis (LVV) may have a similar clinical presentation and should be included in differential diagnostics. A few published case reports and adverse event reports suggest a causal association between LVV and the use of granulocyte colony-stimulating factor (G-CSF) and chemotherapy. Our objective was to evaluate the relationship between LVV, G-CSF and chemotherapy. METHODS Between 2016 and 2018, we identified six patients in Finland with probable drug-induced LVV associated with G-CSF and chemotherapy. All six patients had breast cancer. A systematic literature review was performed according to PRISMA guidelines using comprehensive search terms for cancer, chemotherapy, G-CSF and LVV. RESULTS The literature search identified 18 similar published case reports, of which most were published after 2014. In all patients combined (n = 24), the time delay from the last drug administration to the LVV symptoms was on average 5 days with G-CSF (range = 1-8 days) and 9 days with chemotherapy (range = 1-21 days). Common symptoms were fever (88%), neck pain (50%) and chest pain (42%). Based on imaging, 17/24 (71%) had vascular inflammation in the thoracic aorta and supra-aortic vessels, but 5/24 (21%) reportedly had inflammation limited to the carotid area. CONCLUSION This review suggests that LVV may be a possible serious adverse event associated with G-CSF and chemotherapy. Successful management of drug-induced LVV requires early identification, through diagnostic imaging, and discontinuation of the drug.
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Affiliation(s)
- Kirsi Taimen
- Center for Rheumatology and Clinical Immunology, Division of Medicine, Turku University Hospital, Turku
- Department of Internal Medicine, University of Turku, Turku
| | - Samu Heino
- Center for Rheumatology and Clinical Immunology, Division of Medicine, Turku University Hospital, Turku
- Department of Internal Medicine, University of Turku, Turku
| | - Ia Kohonen
- Department of Radiology, Turku University Hospital, Turku
| | - Heikki Relas
- Department of Rheumatology, Helsinki University Hospital, Helsinki
| | - Riikka Huovinen
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku
| | - Arno Hänninen
- Department of Clinical Microbiology and Immunology, Turku University Hospital, Turku, Finland
| | - Laura Pirilä
- Center for Rheumatology and Clinical Immunology, Division of Medicine, Turku University Hospital, Turku
- Department of Internal Medicine, University of Turku, Turku
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6
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Segmental arterial mediolysis. RADIOLOGIA 2019. [DOI: 10.1016/j.rxeng.2019.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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An imaging-based review of systemic therapies and associated toxicities in metastatic pancreatic cancer as per the 2018 ASCO guidelines: what every radiologist should know. Abdom Radiol (NY) 2019; 44:2182-2195. [PMID: 30820626 DOI: 10.1007/s00261-019-01954-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To provide an overview of what radiologists should know about systemic agents utilized in the modern treatment of metastatic pancreatic cancer and their associated toxicities. RESULTS The clinical landscape of metastatic pancreatic cancer has significantly evolved in recent years, with the advent of new first- and second-line systemic therapies. As these systemic treatment options continue to expand, knowledge of their clinically relevant features is becoming critical for radiologists. While the issues of surgical resectability and tumor response evaluation of advanced stages of pancreatic cancer have been thoroughly discussed in the radiology literature, the diagnostic importance of systemic therapies has tended to be less well appreciated. In this review, we provide a primer for radiologists outlining the radiologically pertinent features of modern systemic therapies used in the treatment of metastatic pancreatic ductal adenocarcinoma. These systemic agents are discussed from the standpoint of the newly updated 2018 ( https://doi.org/10.1007/s00261-019-01954-z ) guidelines for the treatment of metastatic pancreatic cancer from the American Society of Clinical Oncology (ASCO). Understanding the radiology relevance of these modern therapeutic agents is critical, especially with regard to treatment response and toxicity assessment. CONCLUSION Knowledge of the modern systemic therapies utilized in the treatment of metastatic pancreatic cancer and their associated toxicity profiles is critical in diagnostic imaging interpretation.
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Jurado Basildo C, Santos Armentia E, Silva Priege N, Villanueva Campos AM. Segmental arterial mediolysis. RADIOLOGIA 2019; 61:430-434. [PMID: 31155224 DOI: 10.1016/j.rx.2019.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 01/03/2019] [Accepted: 04/10/2019] [Indexed: 11/19/2022]
Abstract
This article reports the case of a 51-year-old woman in whom brain MRI to follow up multiple sclerosis incidentally discovered an intramural hematoma in the extracranial internal carotid artery. MR angiography of the supra-aortic trunks and CT angiography of the aorta showed arterial dilations, aneurysms, dissections, and intramural hematomas in the internal carotid arteries, vertebral arteries, and arteries in the splanchnic territory. These findings raised suspicion of segmental arterial mediolysis. After 6 months of treatment with antiplatelet drugs, the arterial involvement resolved. Segmental arterial mediolysis is an uncommon disease; low clinical suspicion and radiologists' lack of knowledge about this entity mean that it can go undetected or be confused with other vasculitides. This report describes the most relevant pathophysiological findings and correlates them with the imaging findings.
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Affiliation(s)
- C Jurado Basildo
- Departamento de Radiología, Hospital Povisa, Vigo, Pontevedra, España.
| | - E Santos Armentia
- Departamento de Radiología, Hospital Povisa, Vigo, Pontevedra, España
| | - N Silva Priege
- Departamento de Radiología, Hospital Povisa, Vigo, Pontevedra, España
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Webb K, Prakash V, Kirresh O, Stewart A. A case of aortitis during cisplatin-based chemotherapy for cervical cancer. BJR Case Rep 2019; 5:20180054. [PMID: 31131127 PMCID: PMC6519499 DOI: 10.1259/bjrcr.20180054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/19/2018] [Accepted: 08/06/2018] [Indexed: 11/19/2022] Open
Abstract
A case of aortitis in a patient undergoing adjuvant cisplatin and topotecan
chemotherapy for cervical cancer following presentation with pyrexia of unknown
origin and raised inflammatory markers is presented. Although many chemotherapy
agents are known to cause small vessel vasculitis and there are several reported
cases of large vessel vasculitis following gemcitabine chemotherapy, there is
only one previously described case of aortitis following cisplatin
administration. This case is presented with corresponding CT and
18F-FDG PET-CT imaging with discussion of the literature regarding
vasculitis and chemotherapy.
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Affiliation(s)
- Katharine Webb
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | - Vineet Prakash
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | - Othman Kirresh
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
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Chan A, Song M, De Guzman Langit MR, Lim TA, Fong W, Tay K, Lim ST, Tang T. Carotid artery inflammation associated with gemcitabine-based therapy: a special report. Future Oncol 2015. [DOI: 10.2217/fon.15.111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Vasculitis is an inflammation that can present as acute or chronic in nature, which causes changes in the walls of blood vessels, including thickening, weakening, narrowing and scarring. Gemcitabine, an antimetabolite chemotherapeutic agent, is generally well tolerated with a favorable side effect profile. However, there is increasing evidence that it is associated with vasculitis, which can affect small and large vessels. In this case report, we report a patient who has experienced fever with severe tenderness over right carotid artery, which occurred on the fifth day after the administration of gemcitabine. The exact mechanism of gemcitabine-induced vasculitis is unknown but cessation of gemcitabine and initiation of anti-inflammatory treatment appears to aid in the resolution of the clinical syndrome.
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Affiliation(s)
- Alexandre Chan
- Department of Pharmacy, National University of Singapore, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | - Mingjun Song
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610
| | | | - Teh Aun Lim
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - Warren Fong
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore
| | - Kevin Tay
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610
| | - Soon Thye Lim
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610
| | - Tiffany Tang
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610
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11
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Viswanathan C, Carter BW, Shroff GS, Godoy MCB, Marom EM, Truong MT. Pitfalls in oncologic imaging: complications of chemotherapy and radiotherapy in the chest. Semin Roentgenol 2015; 50:183-91. [PMID: 26002238 DOI: 10.1053/j.ro.2015.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Chitra Viswanathan
- Division of Diagnostic Imaging, UT MD Anderson Cancer Center, Houston, TX.
| | - Brett W Carter
- Division of Diagnostic Imaging, UT MD Anderson Cancer Center, Houston, TX
| | - Girish S Shroff
- Division of Diagnostic Imaging, UT MD Anderson Cancer Center, Houston, TX
| | - Myrna C B Godoy
- Division of Diagnostic Imaging, UT MD Anderson Cancer Center, Houston, TX
| | - Edith M Marom
- Department of Diagnostic Imaging, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Mylene T Truong
- Division of Diagnostic Imaging, UT MD Anderson Cancer Center, Houston, TX
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Hayashi S, Maruoka S, Takahashi N, Hashimoto S. Carotidynia after anticancer chemotherapy. Singapore Med J 2014; 55:e142-4. [PMID: 25273942 DOI: 10.11622/smedj.2014127] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Carotidynia is characterised by inflammation limited to the common carotid artery, which has been recognised as a distinct disease entity by advanced vascular imaging. Although most cases of carotidynia are idiopathic, we herein present a case of carotidynia after anticancer chemotherapy. A 64-year-old male patient received docetaxel followed by granulocyte-colony stimulating factor (G-CSF) for the treatment of lung squamous carcinoma. After the treatment, bilateral cervical pain developed. Vascular imaging, including magnetic resonance imaging, computed tomography and ultrasonography, showed characteristics specific for carotidynia. Although there was no strong confirmation using tests such as a challenge test, our observations suggest that docetaxel or G-CSF could be a causative drug triggering carotidynia.
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Affiliation(s)
- Shinichi Hayashi
- Division of Respiratory Medicine, Nihon University School of Medicine, 30-1 Ohyaguchikamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
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Gemcitabine-induced large vessel vasculitis demonstrated by PET CT: a rare, important side effect. Int J Hematol 2014; 99:798-800. [PMID: 24584910 DOI: 10.1007/s12185-014-1555-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 02/20/2014] [Accepted: 02/20/2014] [Indexed: 10/25/2022]
Abstract
Gemcitabine is a nucleoside analogue used widely across haemato-oncology. Side effects are generally predictable, and typically consist of cytopenia, nausea, and infection. As the present case clearly demonstrates, gemcitabine is in rare cases associated with life-threatening large vessel vasculitis, which can involve the aorta. It is important to consider gemcitabine-induced vasculitis in non-specifically unwell patients with raised inflammatory markers and fever of unknown origin, with or without signs of vascular compromise. Early recognition, cessation of gemcitabine therapy, and high-dose steroids are critical for a good outcome. PET CT is valuable to diagnose large vessel vasculitis and monitor treatment response.
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Cabero Moyano J, Andreu Magarolas M, Castañer González E, Gallardo Cistaré X, Belmonte Castan E. Patología aórtica no urgente: diagnóstico clínico-radiológico de la aortitis. RADIOLOGIA 2013; 55:469-82. [DOI: 10.1016/j.rx.2013.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/09/2013] [Accepted: 05/04/2013] [Indexed: 12/26/2022]
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Nonurgent aortic disease: Clinical-radiological diagnosis of aortitis. RADIOLOGIA 2013. [DOI: 10.1016/j.rxeng.2013.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Contreras-Steyls M, López-Navarro N, Gallego E, Moyano B, Estrada D, Herrera E. Gemcitabine therapy-associated cutaneous vasculitis with a polyarteritis nodosa-like pattern. Int J Dermatol 2013; 52:1029-31. [DOI: 10.1111/j.1365-4632.2011.05074.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gemcitabine-induced extensive skin necrosis. Case Rep Med 2012; 2012:831616. [PMID: 23304162 PMCID: PMC3523642 DOI: 10.1155/2012/831616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 10/29/2012] [Indexed: 11/17/2022] Open
Abstract
An 82-year-old woman presented with oedema and extensive necrotic ulcerative lesions on the back side of her lower limbs, emerging after the second cycle of chemotherapy consisting of Gemcitabine for metastatic pancreatic cancer. The absence of any convincing argument in favor of cardiovascular or autoimmune disease led us to attribute the onset of skin necrosis to chemotherapy administration. Although skin ischemia has also been described as a paraneoplastic syndrome, in this case we could observe a temporal and causal relationship to Gemcitabine infusion. Recently, this drug has been associated with important vascular side effects; its vascular toxicity is in fact higher than previously estimated. To our knowledge, careful attention should be reserved to neoplastic patients candidated to Gemcitabine administration, especially if previously affected by arterial vascular disease, venous thromboembolism, or collagenoses.
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Drug-induced rheumatic diseases: a review of published case reports from the last two years. Curr Opin Rheumatol 2012; 24:182-6. [PMID: 22301868 DOI: 10.1097/bor.0b013e32835059cd] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW New drugs are continuously being developed and some rheumatic syndromes have been associated with specific drugs. As most of the rheumatic diseases are multisystem, it is worthwhile examining the wider case report literature to see whether any recent studies signify new associations between drugs and the rheumatic diseases. The last 2 years' case reports in English were scrutinized for noninfectious association with the rheumatic diseases. Cross-referencing from MEDLINE was performed using several databases including Google scholar; British Medical Journal (BMJ) case reports were also queried separately. RECENT FINDINGS Fifty-three articles comprising 56 case reports are included in the review, with 27 (48.2%) associated with the vasculitides, eight (14.3%) associated with lupus and 13 (23.2%) were associated with the myositis syndromes. The commonest four groups of drugs to potentially induce rheumatic diseases were anti-tumour necrosis factor (TNF) drugs, oncology drugs, propylthiouracil and interferons. SUMMARY It is important to recognise that drugs used in other specialties may induce rheumatic disease and vigilance on making a diagnosis is the key.
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2010. [DOI: 10.1002/pds.1857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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