Reactions 1430 - 1 Dec 2012

SAntineoplastics

Pneumatosis intestinalis: case reportAn 18-year-old man developed pneumatosis intestinalis

following treatment with prednisolone, daunorubicin,vincristine, asparaginase and methotrexate [dosages andnot all routes stated] for B lymphoblastic leukaemia.

The man was hospitalised for consolidationchemotherapy; two months earlier, he receivedprednisolone, vincristine, asparaginase, intrathecalmethotrexate and daunorubicin, an induction regimen, forB lymphoblastic leukaemia. Routine x-rays showedintraperitoneal free air with gas collection along the colonwall. Examination found mild abdominal distension. Testsshowed the following values: haemoglobin 9.9 g/dL,leukocyte count 8.0 × 109/L (87% neutrophils) and plateletcount 278 × 109/L. Extramural and intramural gas of thetransverse and ascending colon was observed by CT inaddition to pneumoretroperitoneum andpneumoperitoneum. He was diagnosed with pneumatosisintestinalis.

Ceftazidime, teicoplanin and metronidazole wereinitiated. The man’s condition subsequently improved;repeat imaging, 2 weeks later, revealed significantregression of pneumatosis intestinalis with resolutionnoted after 4 weeks. Symptoms of acute lymphoblasticleukaemia ensued after a few days necessitating successfulreadministration of vincristine.

Author comment: "[W]e report a rare case ofasymptomatic PI [pneumatosis intestinalis] in an 18-yr-oldman after induction of chemotherapy for B lymphoblasticleukemia".Shin D-K, et al. Asymptomatic pneumatosis intestinalis following chemotherapyfor B lymphoblastic leukemia with recurrent genetic abnormalities in an adolescentpatient. Korean Journal of Hematology 47: 74-76, No. 1, Mar 2012. Availablefrom: URL: http://dx.doi.org/10.5045/kjh.2012.47.1.74 - South Korea 803080516

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Reactions 1 Dec 2012 No. 14300114-9954/10/1430-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved