Reactions 856 - 16 Jun 2001

SAntineoplastics

Scleroderma: case reportScleroderma developed in a girl 9 months after she

completed antineoplastic therapy for metastatic thymiccarcinoma, which was diagnosed when she was aged 13 years.

The girl’s treatment comprised 4 courses of vincristine 1.4mg/m2 on day 1, cisplatin 90 mg/m2 on day 1, doxorubicin 30mg/m2/day on days 1 and 2 and cyclophosphamide 10mg/kg/day on days 1–3, repeated every 3 weeks. Maintenancetherapy comprised cisplatin, dacarbazine, dactinomycin andcyclophosphamide [dosages not stated]. Antineoplastictherapy was stopped after 1 year as there was no tumourrecurrence. Nine months later, she developed numbness ofher hands and colour changes following exposure to coldtemperatures. She had tight, shiny, atrophic skin over her faceand limited movement of her finger muscles. There wasdilatation of her oesophagus and decreased peristalsis, andmild restriction of her pulmonary function. Raynaud’s diseasewas also present.

The girl was diagnosed with possible scleroderma and shewas treated with oral methotrexate, but her attacks ofRaynaud’s disease worsened. Her treatment was changed topenicillamine and prednisolone, but no improvement wasseen during 14 months of follow-up.

Author comment: ‘We strongly suspect that theimmunomodulating drugs used in our case may have played arole in the development of the patient’s scleroderma.’Emir S, et al. Scleroderma in a child after chemotherapy for cancer. Clinical andExperimental Rheumatology 19: 221-223, Mar-Apr 2001 - Turkey 800864470

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Reactions 16 Jun 2001 No. 8560114-9954/10/0856-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved