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Pericarditis after high-dose chemotherapy: more frequent than expected?
Jurgen Bock1, Anna Doenitz, Reinhard Andreesen
1Department of Internal Medicine I, University of Regensburg, Germany.
Onkologie
|July 29, 2006
Summary
Acute pericarditis is a potential chemotherapy side effect, even with treosulfan. Prompt diagnosis and treatment with anti-inflammatories led to full recovery in two patients.
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Pericarditis is a rare chemotherapy side effect, previously documented with drugs like cyclophosphamide and doxorubicin.
- Treosulfan has not been previously associated with pericarditis.
Observation:
- Two patients presented with retrosternal chest pain and characteristic ECG changes indicative of acute pericarditis.
- Both patients had recently undergone high-dose treosulfan-based chemotherapy followed by autologous stem cell transplantation.
- No viral infections were identified, and cardiac biomarkers remained stable, suggesting a non-ischemic etiology.
Findings:
- Elevated C-reactive protein levels were observed within 24 hours of symptom onset.
- One patient experienced paroxysmal supraventricular arrhythmia.
- Treatment with diclofenac resulted in complete recovery within one week for both patients.
Implications:
- Pericarditis should be considered in the differential diagnosis of chest pain in patients receiving high-dose chemotherapy, including treosulfan.
- The exact pathogenesis of treosulfan-induced pericarditis is unknown but may involve direct drug toxicity or immunologic mechanisms.
- Early recognition and anti-inflammatory treatment are crucial for favorable outcomes in chemotherapy-related pericarditis.
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