RESUMEN
INTRODUCTION: The authors report two cases of young patients who developed clubbing and hypertrophic osteoarthropathy in one case or lung diffusion disorder in the second, after a long-term use of bevacizumab plus chemotherapy in a palliative setting of metastatic colorectal cancer. DISCUSSION: We propose that patients on long-term bevacizumab be examined for clubbing and undergo respiratory function tests and that this would be studied prospectively before beginning trials in evaluating this monoclonal antibody given for 2 years in an adjuvant setting.
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Anticuerpos Monoclonales Humanizados/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias Colorrectales/tratamiento farmacológico , Osteoartropatía Hipertrófica Secundaria/inducido químicamente , Adulto , Bevacizumab , Camptotecina/efectos adversos , Camptotecina/análogos & derivados , Femenino , Fluorouracilo/efectos adversos , Humanos , Leucovorina/efectos adversos , Masculino , Osteoartropatía Hipertrófica Secundaria/diagnóstico , Osteoartropatía Hipertrófica Secundaria/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Continuous chronic drug infusion with PGE1 via a portable pump and neuromuscular electrical stimulation (NMES) help to improve the quality of life in patients with severe chronic heart failure waiting for a donor heart, as both treatments can be performed at home. We report a 56-year-old woman suffering from severe chronic heart failure, who was referred for a cardiac rehabilitation program because of progressive muscle weakness and weight loss. Due to her underlying heart disease she was unable to perform voluntary exercise. NMES of both knee extensor muscles was started. Under simultaneous chronic drug infusion with PGE1 via a portable pump the patient developed clinical signs of hypertrophic osteoarthropathy, which prevented her from continuing the rehabilitation program. X-ray examinations and bone scans concurred with the diagnosis of secondary hypertrophic osteoarthropathy. After the PGE1 dose had been reduced, the clinical signs of the osteoarthropathy resolved and the patient was able to continue the rehabilitation program with no difficulty. This case report underlines the importance of being aware of the potential side effects of modern cardiac drugs in the complex treatment of patients waiting for a donor heart.
Asunto(s)
Alprostadil/efectos adversos , Insuficiencia Cardíaca/rehabilitación , Osteoartropatía Hipertrófica Secundaria/inducido químicamente , Alprostadil/administración & dosificación , Huesos/diagnóstico por imagen , Huesos/efectos de los fármacos , Enfermedad Crónica , Terapia Combinada , Femenino , Trasplante de Corazón , Humanos , Bombas de Infusión , Persona de Mediana Edad , Debilidad Muscular/rehabilitación , Osteoartropatía Hipertrófica Secundaria/diagnóstico por imagen , Cintigrafía , Estimulación Eléctrica Transcutánea del Nervio , Listas de EsperaAsunto(s)
Osteoartropatía Hipertrófica Secundaria/inducido químicamente , Extracto de Senna/efectos adversos , Trastornos Relacionados con Sustancias , Adulto , Articulación del Tobillo/diagnóstico por imagen , Femenino , Humanos , Osteoartropatía Hipertrófica Secundaria/diagnóstico por imagen , RadiografíaRESUMEN
Laxative abuse may cause systemic and metabolic changes, but cachexia has not been reported as a predominant feature. A patient with finger clubbing and extreme wasting recovered when senna intake was stopped and nutritional care provided. A diagnosis had been made of acquired common variable hypogammaglobulinaemia with absence of circulating B lymphocytes. The immunological abnormalities were corrected after senna intake was stopped and lean body mass restored.
Asunto(s)
Extracto de Senna , Trastornos Relacionados con Sustancias/complicaciones , Agammaglobulinemia/inducido químicamente , Peso Corporal , Caquexia/inducido químicamente , Femenino , Humanos , Deficiencia de IgG , Persona de Mediana Edad , Osteoartropatía Hipertrófica Secundaria/inducido químicamente , Trastornos Relacionados con Sustancias/rehabilitaciónRESUMEN
A young woman with a previous history of anorexia nervosa presented with severe finger clubbing. Urine samples intermittently contained significant amounts of aspartylglucosamine. Liver biopsy showed abnormal cytoplasmic inclusions in phagocytic cells. The patient was found to be abusing senna laxative.