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Enfermedad pulmonar no tuberculosa asociada con lenvatinib: un informe de caso
Qian Wang1, Lili Du1, Yiming Wang1
1Department of Respiratory and Critical Care Medicine Huangshan City People's Hospital Huangshan Anhui China.
Respirology case reports
|August 22, 2025
Resumen
Un paciente con cáncer de hígado desarrolló una tos debido a una infección por Mycobacterium kansasii. La interrupción del tratamiento con lenvatinib mejoró los síntomas y eliminó las lesiones pulmonares, lo que pone de manifiesto una posible infección inducida por el medicamento.
Área de la Ciencia:
- Investigación del carcinoma hepatocelular
- Diagnóstico de las enfermedades infecciosas
- Efectos secundarios de los medicamentos oncológicos
Sus antecedentes:
- El tratamiento del carcinoma hepatocelular (HCC) a menudo implica terapias dirigidas como el lenvatinib.
- Lenvatinib, un inhibidor de la multicinasa, puede tener varios efectos secundarios.
- Las infecciones oportunistas pueden ocurrir en pacientes inmunocomprometidos o en aquellos en tratamiento a largo plazo.
Objetivo del estudio:
- Informar de un caso raro de infección por Mycobacterium kansasii en un paciente tratado con lenvatinib para el CCH.
- Investigar la posible asociación entre el tratamiento con lenvatinib y el desarrollo de infecciones atípicas.
- Describir los desafíos de diagnóstico y los resultados de la gestión en tales casos.
Principales métodos:
- Informe de caso de un hombre de 64 años con HCC bajo lenvatinib.
- El diagnóstico incluyó broncoscopia con análisis de líquido de lavado.
- Se utilizó la secuenciación de próxima generación (NGS) para la identificación de patógenos.
- El tratamiento clínico incluyó la interrupción del medicamento y el monitoreo de los síntomas.
Principales resultados:
- Las pruebas iniciales de patógenos a través de la broncoscopia fueron negativas.
- La secuenciación de próxima generación (NGS) identificó definitivamente a Mycobacterium kansasii.
- La interrupción del tratamiento con lenvatinib condujo a una mejora significativa en la tos y la rigidez torácica.
- La tomografía computarizada de seguimiento del tórax mostró una resolución completa de las lesiones pulmonares.
Conclusiones:
- Se debe considerar la infección por Mycobacterium kansasii en pacientes con CHC tratados con lenvatinib que presentan síntomas respiratorios.
- La secuenciación de próxima generación (NGS) es una herramienta valiosa para el diagnóstico de infecciones difíciles.
- La interrupción del tratamiento con lenvatinib puede ser un paso crucial en el tratamiento de estas infecciones oportunistas.
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