A case report of fulminant hepatitis due to ribociclib with confirmed by liver biopsy in breast cancer

2021 ◽  
pp. 107815522110279
Author(s):  
Atakan Topcu ◽  
Ayse Irem Yasin ◽  
Abdallah TM Shbair ◽  
Mehmet Besiroglu ◽  
Melih Simsek ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Liver Biopsy ◽  
Fulminant Hepatitis ◽  
Liver Toxicity ◽  
Growth Factor Receptor ◽  
Drug Induced ◽  
Laboratory Findings ◽  
First Case ◽  
Abdominal Mri

Introduction Breast cancer is the most frequently diagnosed cancer in women worldwide. Ribociclib is now frequently used in the treatment of metastatic hormone-positive and human epidermal growth factor receptor 2 (HER 2)-negative breast cancer. Case Report A 54-year-old woman with breast cancer presented at a clinic in November 2017 with multiple lung and bone metastases. After receiving multiple lines of treatment due to disease progression, ribociclib and fulvestrant were initiated. Grade 4 toxicity was observed due to ribociclib during follow-up, and ribociclib was discontinued permanently. Management & Outcome: Given that liver transaminases and bilirubin elevation persisted despite discontinuation of the treatment, other reasons for liver toxicity were investigated. Abdominal MRI showed no liver metastases, although there was acute hepatitis. A liver biopsy was performed to determine the etiology. The pathology result was compatible with drug-induced acute fulminant toxic hepatitis. After liver biopsy, prednisolone treatment was initiated, after which the laboratory findings normalized. Discussion Although there are reported cases showing improvement in liver enzymes after ribociclib discontinuation, in our case, no recovery from hepatotoxicity was noticed. The treatment was changed to another hormonal pathway therapy option, exemestane. To the best of our knowledge, this is the first case in the literature reporting this rare side effect of ribociclib, which is a liver biopsy-proven fulminant hepatitis.

scholarly journals Oral ulcers in patients treated with palbociclib: a case report

2018 ◽  
Vol 24 (2) ◽  
pp. 60-62
Author(s):  
Cédric Alande ◽  
Mathilde Fénélon ◽  
Jean-Christophe Fricain
Keyword(s):  
Breast Cancer ◽  
Growth Factor Receptor ◽  
Pulmonary Involvement ◽  
Infrared Laser ◽  
Drug Induced ◽  
Oral Ulcers ◽  
First Case ◽  
Aphthous Ulcers ◽  
Breast Cancer Relapse ◽  
Er Positive

Introduction: Palbociclib is an approved drug in the treatment of women with advanced or metastatic estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative, breast cancer. The purpose of this article is to present the first case ever described of oral ulcers caused by palbociclib. Observation: A case of drug-induced oral ulcers is reported. The patient was treated with a combination of palbociclib and Fulvestrant for a breast cancer relapse with pulmonary involvement. These ulcers were localized on the ventral face of the tongue and on the gum. A therapeutic combination of infrared laser biostimulation and a topical application of Dermoval® and Dynexan® were carried out. Palbociclib was concurrently discontinued. The lesions healed in about 15 days. Comments: Palbociclib is an inhibitor of cyclin-dependent kinases 4 and 6 (CDK 4/6). Thereby, it blocks many signaling pathways responsible for cell proliferation. This property weakens the oral mucosa and could be the cause of the observed ulcers. These latter having been particularly debilitating for the patient. Conclusion: Palbociclib-related oral aphthous ulcers are similar to those reported with other targeted therapies. The combination of infrared laser biostimulation and local corticosteroid therapy did not prevent the discontinuation of the cancer treatment.

scholarly journals Complications following breast cancer therapy in the adult spina bifida population: A case report

2013 ◽  
Vol 7 (11-12) ◽  
pp. 761
Author(s):  
Nathan Y Hoy ◽  
Peter Metcalfe
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Spina Bifida ◽  
Ileal Conduit ◽  
Subsequent Treatment ◽  
Breast Cancer Chemotherapy ◽  
Cancer Management ◽  
First Case ◽  
Breast Cancer Management ◽  
Neurogenic Bowel

Survival to adulthood in spina bifida has greatly increased with the advent of modern therapies. With this prolonging of life expectancy, patients are exposed to the risk of adult onset malignancies and the complications of subsequent treatment. We present the case of a 66-year-old woman born with a terminal lipomyelomeningocele, presenting with new fecal incontinence and a desire to undivert her ileal conduit. The deterioration was attributed to chemotherapy for breast cancer. We highlight the urologic challenges of breast cancer management in the neurogenic bowel population, as well as the utility of an adult spina bifida clinic. To the best of our knowledge, this is the first case report of a spina bifida patient presenting with fecal and urinary complications from breast cancer chemotherapy.

scholarly journals Long-term remission of a Her2/neu positive primary breast cancer under double monoclonal antibody therapy with trastuzumab and bevacizumab

2014 ◽  
Vol 48 (2) ◽  
pp. 184-188 ◽  
Author(s):  
Robert Königsberg ◽  
Julia Maierhofer ◽  
Tanja Steininger ◽  
Gabriele Kienzer ◽  
Christian Dittrich
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Growth Factor ◽  
Antibody Therapy ◽  
Growth Factor Receptor ◽  
Over Expression ◽  
Single Target ◽  
Epidermal Growth ◽  
Endothelial Growth Factor

AbstractBackground. The attempt to act on several signalling pathways involved in tumour development simultaneously appears to be more attractive than attacking a single target structure alone. Vascular endothelial growth factor (VEGF) over-expression is frequently observed in human epidermal growth factor receptor 2 (Her2/neu) positive patients with breast cancer and over-expression of the proto-oncogene Her2/neu is associated with an up-regulation of VEGF.Case report. The case of a Her2/neu positive patient with breast cancer who refused cytotoxic chemotherapy with its potential side effects as well as mastectomy is presented. Our patient has been receiving the combined double administration of bevacizumab and trastuzumab for more than 4 years.Conclusions. This case report shows that (a) the combined double administration of bevacizumab and trastuzumab was be clinically effective. (b) The combination of bevacizumab and trastuzumab is safe and non-toxic. (c) Bevacizumab and trastuzumab can be used as a long-term application

scholarly journals Case report: a 5-year-old with new onset nephrotic syndrome in the setting of COVID-19 infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kelsi M. Morgan ◽  
Peace D. Imani
Keyword(s):  
Nephrotic Syndrome ◽  
Case Report ◽  
Pediatric Patient ◽  
Corticosteroid Therapy ◽  
Clinical Remission ◽  
Laboratory Findings ◽  
Case Presentation ◽  
The Third ◽  
First Case ◽  
New Onset

Abstract Background This is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient. This is the third case of new-onset nephrotic syndrome in children associated with SARS-CoV-2 infection, but is the first case report describing a new-onset nephrotic syndrome presentation in a patient who had asymptomatic COVID-19 infection. Case presentation This is a case of a previously healthy 5 year old female who presented with new-onset nephrotic syndrome in the setting of an asymptomatic COVID-19 infection. She presented with progressive edema, and laboratory findings were significant for proteinuria and hypercholesterolemia. She was treated with albumin, diuretics, and corticosteroid therapy, and achieved clinical remission of her nephrotic syndrome within 3 weeks of treatment. Though she was at risk of hypercoagulability due to her COVID-19 infection and nephrotic syndrome, she was not treated with anticoagulation, and did not develop any thrombotic events. Conclusions Our case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms.

scholarly journals Drug-Induced Resistance and Phenotypic Switch in Triple-Negative Breast Cancer Can Be Controlled via Resolution and Targeting of Individualized Signaling Signatures

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 5009
Author(s):  
Swetha Vasudevan ◽  
Ibukun A. Adejumobi ◽  
Heba Alkhatib ◽  
Sangita Roy Chowdhury ◽  
Shira Stefansky ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Growth Factor Receptor ◽  
Patient Specific ◽  
Network Structures ◽  
Breast Cancers ◽  
Drug Induced ◽  
Tcga Dataset

Triple-negative breast cancer (TNBC) is an aggressive subgroup of breast cancers which is treated mainly with chemotherapy and radiotherapy. Epidermal growth factor receptor (EGFR) was considered to be frequently expressed in TNBC, and therefore was suggested as a therapeutic target. However, clinical trials of EGFR inhibitors have failed. In this study, we examine the relationship between the patient-specific TNBC network structures and possible mechanisms of resistance to anti-EGFR therapy. Using an information-theoretical analysis of 747 breast tumors from the TCGA dataset, we resolved individualized protein network structures, namely patient-specific signaling signatures (PaSSS) for each tumor. Each PaSSS was characterized by a set of 1–4 altered protein–protein subnetworks. Thirty-one percent of TNBC PaSSSs were found to harbor EGFR as a part of the network and were predicted to benefit from anti-EGFR therapy as long as it is combined with anti-estrogen receptor (ER) therapy. Using a series of single-cell experiments, followed by in vivo support, we show that drug combinations which are not tailored accurately to each PaSSS may generate evolutionary pressure in malignancies leading to an expansion of the previously undetected or untargeted subpopulations, such as ER+ populations. This corresponds to the PaSSS-based predictions suggesting to incorporate anti-ER drugs in certain anti-TNBC treatments. These findings highlight the need to tailor anti-TNBC targeted therapy to each PaSSS to prevent diverse evolutions of TNBC tumors and drug resistance development.

scholarly journals Grade 3 Hepatotoxicity following Fulvestrant, Palbociclib, and Erdafitinib Therapy in a Patient with ER-Positive/PR-Negative/HER2-Negative Metastatic Breast Cancer: A Case Report

2020 ◽  
Vol 13 (1) ◽  
pp. 304-308 ◽  
Author(s):  
Alyssa Schlotman ◽  
Adam Stater ◽  
Kyle Schuler ◽  
Judd Heideman ◽  
Vandana Abramson
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Case Report ◽  
Metastatic Breast ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Hepatotoxic Effect ◽  
Er Positive ◽  
Grade 3 ◽  
Experienced Grade

A 49-year-old woman with ER-positive/PR-negative/HER2-negative metastatic breast cancer experienced Grade 3 hepatotoxicity following initiation of a clinical trial of fulvestrant, palbociclib, and erdafitinib. Fulvestrant was determined to be the drug most likely responsible for this hepatotoxic effect. This case report details the timing and nature of this drug-induced liver injury, adding support to an area that has yet to be described adequately in the existing literature.

Tamoxifen-induced acute mania: A case report

2020 ◽  
Vol 26 (8) ◽  
pp. 2025-2027
Author(s):  
Berker Duman ◽  
Adnan Kuşman ◽  
Burçin Çolak ◽  
Filiz Çay Şenler ◽  
Hakan Kumbasar
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Ductal Carcinoma ◽  
Manic Episode ◽  
Acute Mania ◽  
Psychiatric Evaluation ◽  
Total Mastectomy ◽  
Manic Symptoms ◽  
First Case ◽  
Post Menopausal

Introduction Tamoxifen is widely used for the treatment of hormone-responsive breast cancer, osteoporosis, and post-menopausal symptoms. Also, tamoxifen is currently under investigation for its anti-manic properties. In this article, we report a case who developed manic episode following the initiation of tamoxifen and remitted with discontinuation of the medication. Case Report A 58-year-old woman was diagnosed with breast cancer. Pathologic diagnosis was invasive ductal carcinoma. Following bilateral total mastectomy operation, trastuzumab was initiated with intervals of 21 days. Five days before the fourth application of trastuzumab, tamoxifen was added. On the sixth day following the initiation of tamoxifen, manic symptoms were developed and she was diagnosed as acute mania. Management and Outcome The oncology department suggested withdrawing tamoxifen due to a possible association between tamoxifen initiation and behavioral symptoms. Manic symptoms were rapidly (approximately 24 h) improved following cessation of tamoxifen. Psychiatric evaluation on the fifth day following cessation of tamoxifen revealed no manic symptoms. An aromatase inhibitor-exemestane was initiated and she showed no side effects with this medication since then. Discussion To our knowledge, this is the first case report of probable tamoxifen-induced mania. Our case report at least indicates that there were possibly some patients who were sensitive to the tamoxifen’s nervous system effects, mainly to manic effects. In conclusion, clinicians should be aware of these rare behavioral adverse effects of tamoxifen.

Drug-Induced Esophageal Injury: A Case Report of Percogesic

DICP ◽  
1989 ◽  
Vol 23 (3) ◽  
pp. 227-229 ◽  
Author(s):  
Patrick E. Nwakama ◽  
Harry J. Jenkins ◽  
Robert T. Bailey ◽  
John Pelligrino ◽  
Tom R. Demeester ◽  
...  
Keyword(s):  
Case Report ◽  
Mucosal Injury ◽  
Upright Position ◽  
Esophageal Injury ◽  
Upper Gastrointestinal Endoscopy ◽  
Drug Induced ◽  
First Case ◽  
Retrosternal Pain ◽  
Deep Ulceration ◽  
Dysphagia Treatment

This is the first case report of esophageal injury caused by Percogesic. A 31-year-old healthy white woman presented with dysphagia and retrosternal pain following the ingestion of a Percogesic tablet. The patient felt the tablet lodge in her mid-esophagus even though she ingested it with a cupful of water and in the upright position. Additional fluid was taken to dislodge the tablet with no success. Past medical history was unremarkable for heartburn, regurgitation, or dysphagia. Upper gastrointestinal endoscopy revealed a well-circumscribed deep ulceration in the mid-esophagus. Hospitalization was required due to persistent dysphagia. Treatment consisted of a three-day regimen of liquid antacid, intravenous ranitidine hydrochloride, and metoclopramide. This case emphasizes that pill entrapment can occur in the esophagus in healthy individuals, even when taken in the upright position with plenty of fluid; and mucosal injury can be produced by drugs not generally reported to cause gastrointestinal adverse effects or mucosal injury.

Burning Mouth Syndrome: Problem in the Mouth?

2017 ◽  
Vol 41 (S1) ◽  
pp. S254-S254
Author(s):  
S. Petrykiv ◽  
L. de Jonge ◽  
M. Arts
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Antidepressant Medication ◽  
Burning Mouth Syndrome ◽  
Psychiatric Ward ◽  
Drug Induced ◽  
First Case ◽  
Painful Sensation ◽  
Burning Mouth ◽  
Competing Interest

IntroductionBurning mouth syndrome (BMS) is characterized by an intraoral burning sensation for which no medical or dental cause can be found. Sporadic evidence suggests that drug induced conditions may evoke BMS. Intriguingly, we observed a patient who developed BMS after induction of citalopram.Objectives & aimsA case report of patient with BMS from our psychiatric ward will be presented here, followed by a literature review on drugs induced BMS.MethodsBased on a recent literature search, we present a first case report of BMS that was apparently induced in patient shortly after beginning of citalopram. We performed a systematic search through PubMed, EMBASE and Cochrane's Library to find more cases of psychotropic induced BMS.ResultsMs. A. was a 72-year old woman meeting DSM-IV diagnostic criteria for melancholic depression, who was observed in a clinical setting. We started citalopram 10 mg. 1dd1, with 10 mg. 1dd1 increase over 7 days to 20 mg, 1dd1. The following day, she displayed a persistent burning painful sensation in the mouth. Other than BMS oropharyngological syndromes were excluded after consultation with qualified medical specialists. Citalopram therapy was discontinued, and nortrilen treatment was initiated. BMS symptoms resolved over four days. Twelve case reports have linked BMS to the use antidepressants and anxiolytics.ConclusionContrasting the statement that no medical cause can be found for BMS, we found that psychotropics may evoke the syndrome. Compared to other psychotropic drugs, antidepressant medication has the strongest association with BMS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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