Digital Ischemia and Necrosis: A Rarely Described Complication of Gemcitabine in Pancreatic Adenocarcinoma
| Autor: | Andrea Wang-Gillam, Eiichiro So, Danielle Crites, Zachary Crees |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty Ischemia Case Report lcsh:RC254-282 Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine pancreatic adenocarcinoma medicine Adverse effect 030219 obstetrics & reproductive medicine business.industry gemcitabine Metastatic Pancreatic Adenocarcinoma lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Gemcitabine 030220 oncology & carcinogenesis Toxicity Etiology Adenocarcinoma digital ischemia business Complication digital necrosis medicine.drug |
| Zdroj: | Journal of Pancreatic Cancer Journal of Pancreatic Cancer, Vol 3, Iss 1, Pp 49-52 (2017) |
| ISSN: | 2475-3246 |
| DOI: | 10.1089/pancan.2017.0012 |
| Popis: | Background: Gemcitabine, alone or in combination with other agents, has become an important part of the standard of care for treatment of both resectable and unresectable/advanced pancreatic adenocarcinoma. Gemcitabine is generally considered to have a favorable toxicity profile, with myelosuppression and hepatotoxicity as the most common adverse effects. There are just two prior published case reports of gemcitabine-associated digital toxicity in the treatment of pancreatic adenocarcinoma, and few case reports when considering all solid tumors. Presentation: A 70-year-old female developed hand numbness and tingling while receiving nab-paclitaxel plus gemcitabine for metastatic pancreatic adenocarcinoma. There was initial concern for Raynaud's or nab-paclitaxel-associated neuropathy, thus nab-paclitaxel was discontinued. However, her symptoms progressed to severe pain and her digits became dusky. An extensive evaluation revealed no alternative etiology except gemcitabine-associated digital ischemia (DI). The patient was treated with discontinuation of gemcitabine, and starting nitrates, opiates, calcium-channel blockers, and enoxaparin but eventually progressed to dry gangrene. Conclusion: Here we report a case of gemcitabine-associated DI, along with a review of the literature. Although a rare complication, DI must be recognized and treated promptly to reduce the likelihood of serious and permanent morbidity. |
| Databáze: | OpenAIRE |
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