Recurrent, multisystem angioedema induced by 5-azacitidine
Ruba Alchaikh Hassan1, Shiva Salmasi1, Zahra Ghafarzadeh1
1Department of Internal Medicine, Eisenhower Health, Rancho Mirage, CA, USA.
Summary
A rare case of angioedema, a serious allergic reaction, occurred in a patient treated with 5-azacitidine for myelodysplastic syndrome/myeloproliferative neoplasms. Discontinuation of 5-azacitidine resolved the angioedema.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- 5-azacitidine is a hypomethylating agent used for myelodysplastic syndrome (MDS) and myeloproliferative neoplasms (MPNs).
- Common side effects include myelosuppression and gastrointestinal issues; serious allergic reactions are rare.
- Angioedema is a rare but serious adverse event associated with certain medications.
Purpose of the Study:
- To report a unique case of recurrent, multisystem angioedema potentially induced by 5-azacitidine.
- To highlight the diagnostic challenges and management of this rare adverse reaction.
- To contribute to understanding the side effect profile of 5-azacitidine.
Main Methods:
- Case report of a 71-year-old male patient with MDS/MPN.
- Detailed description of angioedema episodes and their correlation with subcutaneous 5-azacitidine treatment.
- Causality assessment using the Naranjo nomogram, resulting in a score of 9.
Main Results:
- The patient experienced recurrent angioedema affecting multiple body areas, including the neck, genitalia, and gastrointestinal system.
- Angioedema episodes persisted even after dose reduction of 5-azacitidine.
- Discontinuation of 5-azacitidine led to the resolution of angioedema, with steroids proving effective for symptom reversal.
Conclusions:
- 5-azacitidine can be associated with rare, recurrent, and multisystem angioedema.
- Diagnosis may require careful clinical observation and consideration of drug causality.
- Supportive and symptomatic treatment is crucial, and further research is needed to elucidate the underlying mechanisms.
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