RESUMO
Everolimus is an mTOR inhibitor, approved as a treatment for cancer and as an immunosuppressant agent in solid organ transplantation; it frequently produces toxic metabolic effects, particularly of the most severe kind. Its use can cause hyperglycemia, hypercholesterolemia and hypertriglyceridemia; thus, metabolic values should be monitored regularly to prevent these adverse events. We present the case of a woman with an intestinal neuroendocrine tumor who developed two episodes of acute pancreatitis, secondary to severe hypertriglyceridemia caused by everolimus. After treatment with fibrates and omega-3, triglyceride levels returned to baseline, without developing new metabolic or digestive complications. Targeted levels of triglyceride for cancer patients treated with everolimus, should be below 500 or 300 mg/dL, depending on whether life expectancy is less or longer than one year, respectively.
Assuntos
Antineoplásicos/efeitos adversos , Everolimo/efeitos adversos , Hipertrigliceridemia/induzido quimicamente , Hipolipemiantes/uso terapêutico , Neoplasias do Íleo/tratamento farmacológico , Tumores Neuroendócrinos/tratamento farmacológico , Pancreatite/etiologia , Feminino , Humanos , Hipertrigliceridemia/complicações , Hipertrigliceridemia/tratamento farmacológico , Pessoa de Meia-IdadeRESUMO
This corrects the authors listed in "Takotsubo syndrome and hyperthyroidism: a case report" published in volume 42(2) pages 215-220, doi: 10.23938/ASSN.0713.
RESUMO
Stress cardiomyopathy, or Takotsubo syndrome, is similar to that of an acute coronary syndrome, with electrocardiographic changes and an increase in troponin levels; however, coronary arteriography typically shows no obstructive lesions. One of the characteristic patterns are regional wall motion abnormalities identified by echocardiography. It has been described in association with thyroid disorders, although the causal mechanism is not clearly established. We present the case of a woman with acute chest pain and electrical and analytical changes. A severe ventricular dysfunction was observed but the coronary tree was free of lesions, all of which was compatible with a stress cardiomyopathy. Hyperthyroidism due to Graves' disease was observed as a trigger. The identification and management of clinical factors that might predispose patients to Takotsubo syndrome or impact on subsequent clinical outcome is mandatory.