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Gemcitabine-induced gouty arthritis attacks
Sal Bottiglieri1, Neil Tierson, Raina Patel
1Department of Pharmacy, Stratton Veterans Affairs Medical Center, Albany, NY 12208, USA. sal.bottiglieri@acphs.edu
Summary
Gemcitabine chemotherapy can trigger gout attacks in patients with pancreatic cancer. Prophylactic treatment with allopurinol and colchicine effectively prevented these attacks during subsequent gemcitabine therapy.
Area of Science:
- Oncology
- Rheumatology
Background:
- A patient with Stage IIb pancreatic cancer and a history of gout presented for treatment.
- The patient had undergone a Whipple procedure and received adjuvant chemoradiation.
Observation:
- Weekly gemcitabine chemotherapy precipitated acute gouty arthritis attacks.
- Attacks required emergency treatment and led to chemotherapy discontinuation.
- Gout symptoms recurred upon reintroduction of gemcitabine after chemoradiation.
Findings:
- This is the first case report detailing gout attacks associated with gemcitabine therapy.
- Prophylactic allopurinol and colchicine administration prevented gout attacks during subsequent gemcitabine chemotherapy.
- Limited data exists on the mechanism of gemcitabine-induced gouty arthritis.
Implications:
- Patients receiving gemcitabine chemotherapy, especially those with a history of gout, require careful monitoring for gouty arthritis.
- Prophylactic management may be necessary to mitigate gemcitabine-induced gout attacks.
- Further research is needed to elucidate the mechanism of gemcitabine-precipitated gout.
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