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[Severe systemic vasculitis induced by ibrutinib].

M Fenot1, P Woaye Hune2, S Vigouroux3

  • 1Dermatologie, CHD Vendée, Les Oudairies, boulevard Stéphane-Moreau, 85925 La-Roche-sur-Yon, France.

La Revue De Medecine Interne
|November 11, 2023
PubMed
Summary
This summary is machine-generated.

Bruton's tyrosine kinase inhibitors like ibrutinib can cause severe vasculitis. Discontinuation of ibrutinib led to improvement in ulceronecrotic skin lesions, suggesting a drug-induced immunoallergic mechanism.

Keywords:
IbrutinibInhibiteurs de tyrosine kinaseTyrosine kinase inhibitorsVasculariteVasculitis

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Area of Science:

  • Oncology
  • Dermatology
  • Immunology

Background:

  • Cutaneous toxicities of Bruton's tyrosine kinase (BTK) inhibitors are not well-documented.
  • This study investigates a rare case of systemic vasculitis potentially induced by ibrutinib.

Observation:

  • A patient with chronic lymphocytic leukemia developed ulceronecrotic lesions on toes and tongue 18 months after starting ibrutinib.
  • Skin biopsy confirmed vasculitis of small and medium vessels.
  • The condition was unresponsive to corticosteroids and azathioprine.

Findings:

  • Discontinuation of ibrutinib resulted in significant improvement of the skin lesions.
  • The vasculitis was hypothesized to be drug-induced, likely via an immunoallergic pathway.
  • Standard biologic tests for vasculitis were negative.

Implications:

  • This case highlights a severe, potentially immunoallergic cutaneous adverse effect of ibrutinib.
  • Clinicians should consider ibrutinib-induced vasculitis in patients presenting with unexplained ulcerative skin lesions.
  • Further research into BTK inhibitor-related vasculitis is warranted.