Drug induced lupus associated with Trastuzumab emtansine in a patient with metastatic breast cancer.

IF 1 4区 医学 Q4 ONCOLOGY
Oğuzhan Yıldız, Ali Fuat Gürbüz, Melek Karakurt Eryılmaz, Murat Araz, Talat Aykut, Özlem Şahin, Naciye Hilal Büyükboyacı, Zeliha Çelik, Mehmet Artaç
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引用次数: 0

Abstract

Introduction: Ado-trastuzumab emtansine (T-DM1) is employed in the treatment of patients with HER2-positive breast cancer. The most common side effects are fatigue, diarrhoea, anaemia, transaminase elevation and drug-induced thrombocytopenia. This report describes a patient with metastatic breast cancer who developed drug-induced lupus due to T-DM1.

Case report: A 54-year-old woman was diagnosed with breast cancer in March 2018. She underwent modified radical mastectomy and axillary lymph node dissection (pT2N1aM0). Following supraclavicular lymph node metastasis in May 2018, she received 8 cycles of docetaxel, trastuzumab, and pertuzumab. In December 2020, the patient presented with axillary and intra-abdominal lymph node metastases, along with bone metastases observed on PET/CT scan. Treatment with T-DM1 and zoledronic acid was initiated. After 18 months on T-DM1, she developed drug-induced lupus. Her symptoms resolved with hydroxychloroquine treatment and discontinuation of T-DM1.

Discussion: Drug-induced lupus is a clinical syndrome that shares similar features with systemic lupus erythematosus (SLE). The majority of patients present with symptoms such as arthralgia and myalgia. Hydralazine and procainamide are high-risk drugs for drug-induced lupus. Symptoms usually develop after months or years of use, but may also develop suddenly. Our patient also received TDM-1 treatment for 18 months. We present a case of TDM-1-associated drug-induced lupus in a patient with metastatic breast cancer. This is the first case of TDM-1-related drug-induced lupus reported in the literature.

一名转移性乳腺癌患者因使用曲妥珠单抗埃坦新(Trastuzumab emtansine)而诱发狼疮。
简介Ado-trastuzumab emtansine(T-DM1)用于治疗HER2阳性乳腺癌患者。最常见的副作用是疲劳、腹泻、贫血、转氨酶升高和药物引起的血小板减少。本报告描述了一名转移性乳腺癌患者因服用 T-DM1 而导致药物诱发狼疮的病例:一名 54 岁的女性于 2018 年 3 月被诊断为乳腺癌。她接受了改良根治性乳房切除术和腋窝淋巴结清扫术(pT2N1aM0)。2018 年 5 月锁骨上淋巴结转移后,她接受了 8 个周期的多西他赛、曲妥珠单抗和百妥珠单抗治疗。2020年12月,患者出现腋窝和腹腔内淋巴结转移,同时在PET/CT扫描中观察到骨转移。患者开始接受T-DM1和唑来膦酸治疗。服用T-DM1 18个月后,她患上了药物性狼疮。经羟氯喹治疗并停用T-DM1后,她的症状缓解:讨论:药物性狼疮是一种临床综合征,与系统性红斑狼疮(SLE)具有相似的特征。大多数患者表现为关节痛和肌痛等症状。氯丙嗪和普鲁卡因胺是药物诱发狼疮的高危药物。症状通常在使用数月或数年后出现,但也可能突然出现。我们的患者也接受了 18 个月的 TDM-1 治疗。我们报告了一例转移性乳腺癌患者的 TDM-1 相关药物诱发狼疮病例。这是文献中报道的首例TDM-1相关药物诱发狼疮病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.70
自引率
7.70%
发文量
276
期刊介绍: Journal of Oncology Pharmacy Practice is a peer-reviewed scholarly journal dedicated to educating health professionals about providing pharmaceutical care to patients with cancer. It is the official publication of the International Society for Oncology Pharmacy Practitioners (ISOPP). Publishing pertinent case reports and consensus guidelines...
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