Document Detail


Gemcitabine-associated large vessel vasculitis presenting as fever of unknown origin.
MedLine Citation:
PMID:  20407388     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Gemcitabine is a nucleoside analogue used for treatment of multiple cancers. Recent reports describe small to medium vessel vasculitis as a rare complication of therapy. We report a case of significant large vessel vasculitis presenting as fever of unknown origin in a patient treated adjuvantly with docetaxel and gemcitabine for uterine leiomyosarcoma.The patient presented after her first and second exposure to chemotherapy with fever of unknown origin and worsening subsequent chest and neck discomfort. Extensive workup revealed radiographic and laboratory evidence of aortic vasculitis. We initiated treatment with high-dose corticosteroids, and the patient's condition resolved without complication over the next several weeks.To our knowledge, this represents the first case of gemcitabine-induced large vessel vasculitis which presented in our case as fever of unknown origin. Awareness of this potential complication is essential as discontinuing the inciting drug and initiating corticosteroid treatment can be life-saving.
Authors:
Laura B Ramsay; Michael P Stany; Jess D Edison; Sarah A Bernstein; Kevin E Schlegal; Chad A Hamilton
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases     Volume:  16     ISSN:  1536-7355     ISO Abbreviation:  J Clin Rheumatol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-31     Completed Date:  2010-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9518034     Medline TA:  J Clin Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-2     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC 20307, USA.
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MeSH Terms
Descriptor/Qualifier:
Antimetabolites, Antineoplastic / adverse effects*
Aortitis / chemically induced*,  complications,  radionuclide imaging
Deoxycytidine / adverse effects,  analogs & derivatives*
Female
Fever of Unknown Origin / etiology
Fluorodeoxyglucose F18 / diagnostic use
Humans
Middle Aged
Positron-Emission Tomography
Chemical
Reg. No./Substance:
0/Antimetabolites, Antineoplastic; 103882-84-4/gemcitabine; 63503-12-8/Fluorodeoxyglucose F18; 951-77-9/Deoxycytidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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