Antineoplastics
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Reactions 680 - 6 Dec 1997 S Antineoplastics Constrictive pericarditis?: case report A 52-year-old woman developed constrictive pericarditis following high-dose antineoplastic therapy for breast cancer. Following a mastectomy, the woman was treated with 4 courses of fluorouracil 500 mg/m 2 , epirubicin 90 mg/m 2 and cyclophosphamide 500 mg/m 2 daily every 3 weeks, followed by high-dose antineoplastic therapy with cyclophosphamide 6 g/m 2 , carboplatin 1600 mg/m 2 and thiotepa 480 mg/m 2 divided over 4 days. On day 7, peripheral stem-cell reinfusion was administered. Two months after receiving the high-dose antineoplastic regimen, the woman developed pericardial effusion without tamponade. The pericardial effusion was attributed to cyclophosphamide and she was treated with furosemide. Two weeks later, she was hospitalised with exertional dyspnoea. She had distended neck veins, pulsus paradoxus of 30mm Hg, a decrease in ECG voltage and liver function disorders. Swan- Ganz catheterisation was consistent with constrictive pericarditis. She underwent midsternal thoracotomy and pericardial stripping was performed. Histological examination of the surgical specimen showed pericardial thickening due to proliferation of myofibroblasts. The woman’s condition improved and she was discharged 2 weeks later. At follow-up after 3 months, she had returned to work. Author comment: ‘The cause of this constrictive pericarditis was not established but it may be associated with high-dose chemotherapy . . . when more frequent causes of dyspnoea such as pleural effusion, left ventricular failure, and malignancy have been excluded the clinician should be alerted to this potential complication of high-dose chemotherapy.’ Tulleken JE, et al. Constrictive pericarditis after high-dose chemotherapy. Lancet 350: 1601, 29 Nov 1997 - Netherlands 800651732 1 Reactions 6 Dec 1997 No. 680 0114-9954/10/0680-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 680 - 6 Dec 1997
SAntineoplastics
Constrictive pericarditis?: case reportA 52-year-old woman developed constrictive pericarditis
following high-dose antineoplastic therapy for breast cancer.Following a mastectomy, the woman was treated with 4
courses of fluorouracil 500 mg/m2, epirubicin 90 mg/m2 andcyclophosphamide 500 mg/m2 daily every 3 weeks, followedby high-dose antineoplastic therapy with cyclophosphamide 6g/m2, carboplatin 1600 mg/m2 and thiotepa 480 mg/m2 dividedover 4 days. On day 7, peripheral stem-cell reinfusion wasadministered.
Two months after receiving the high-dose antineoplasticregimen, the woman developed pericardial effusion withouttamponade. The pericardial effusion was attributed tocyclophosphamide and she was treated with furosemide. Twoweeks later, she was hospitalised with exertional dyspnoea.She had distended neck veins, pulsus paradoxus of 30mm Hg,a decrease in ECG voltage and liver function disorders. Swan-Ganz catheterisation was consistent with constrictivepericarditis. She underwent midsternal thoracotomy andpericardial stripping was performed. Histological examinationof the surgical specimen showed pericardial thickening due toproliferation of myofibroblasts.
The woman’s condition improved and she was discharged 2weeks later. At follow-up after 3 months, she had returned towork.
Author comment: ‘The cause of this constrictive pericarditiswas not established but it may be associated with high-dosechemotherapy . . . when more frequent causes of dyspnoeasuch as pleural effusion, left ventricular failure, and malignancyhave been excluded the clinician should be alerted to thispotential complication of high-dose chemotherapy.’Tulleken JE, et al. Constrictive pericarditis after high-dose chemotherapy. Lancet350: 1601, 29 Nov 1997 - Netherlands 800651732
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Reactions 6 Dec 1997 No. 6800114-9954/10/0680-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
