Acute acalculous cholecystitis
| Autor: | Cindy Kortepeter, Corrinne G. Kulick, Allen Brinker, David Croteau, Charlene M. Flowers |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Risk
0301 basic medicine medicine.medical_specialty Cholecystitis Acute Population 03 medical and health sciences Adverse Event Reporting System Multiple Sclerosis Relapsing-Remitting 0302 clinical medicine Internal medicine Pharmacovigilance medicine Humans Immunologic Factors education Adverse effect Alemtuzumab Acalculous Cholecystitis education.field_of_study business.industry Multiple sclerosis medicine.disease 030104 developmental biology Cholecystitis Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug Medical literature |
| Zdroj: | Neurology. 90:e1548-e1552 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0000000000005422 |
| Popis: | ObjectiveTo evaluate acute acalculous cholecystitis (AAC) as a potential safety risk for patients treated with alemtuzumab.MethodsThe Food and Drug Administration Adverse Event Reporting System and the medical literature were searched for cases of AAC in conjunction with alemtuzumab for all clinical indications.ResultsEight spontaneously reported cases meeting the case definition of AAC in close temporal association with alemtuzumab use were identified. Based on established criteria within the Food and Drug Administration Division of Pharmacovigilance for causality assessment, 4 cases were assessed as probable while 4 were possible. All cases occurred in patients with relapsing-remitting multiple sclerosis. Seven of the 8 cases presented with AAC during or shortly after alemtuzumab treatment, thereby suggesting an acute cytokine release syndrome as a putative pathogenic mechanism. The cases identified in this review differ from the typical AAC cases described in the medical literature based on female preponderance, lack of concurrent critical illnesses, inconsistent presence of other risk factors, and resolution with conservative treatment in the majority of cases.ConclusionsAAC represents a new and potentially life-threatening adverse event associated with alemtuzumab use in relapsing-remitting multiple sclerosis. In cases seen to date, early and conservative treatment resulted in good clinical outcome, although the natural history of AAC in this population without critical illness is not well defined. Awareness of this safety risk by general and specialty neurologists is important for prompt recognition and optimal management. |
| Databáze: | OpenAIRE |
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