RESUMO
We report the case of a 79-year-old male who had undergone surgery for a mucus-secreting, stage-III pancreatic adenocarcinoma 2 years previously, who was recently started on capecitabine monotherapy for radiographic local progression. He developed disorientation, asterixis, nausea and elevated serum ammonia (221 µmol/L) 48-72 hours after treatment onset with preserved liver function. After ruling out potential causes of encephalopathy and tumor progression by abdominal and brain CT scans, his symptoms were related by exclusion to the recently initiated treatment with capecitabine. Capecitabine discontinuation, onset of standard anti-encephalopathy measures, and intravenous hydration led to a rapid, complete resolution of symptoms with serum ammonia normalization.
Assuntos
Adenocarcinoma , Encefalopatias , Hiperamonemia , Neoplasias Pancreáticas , Adenocarcinoma/tratamento farmacológico , Idoso , Amônia , Encefalopatias/induzido quimicamente , Encefalopatias/diagnóstico por imagem , Capecitabina/efeitos adversos , Humanos , Hiperamonemia/induzido quimicamente , MasculinoRESUMO
No disponible
Assuntos
Humanos , Feminino , Idoso , Pancreatite/induzido quimicamente , Bortezomib/efeitos adversos , Pancreatite/complicações , Pancreatite/etiologia , Tomografia Computadorizada por Raios X , Dor Abdominal/etiologiaRESUMO
Eosinophilic enterocolitis is a rare entity included in the group of primary eosinophilic gastrointestinal disorders. It is characterized by eosinophilic infiltrate in the absence of other causes of enterocolonic eosinophilia (infection, allergic or drug reaction, inflammatory disease, etc). The most common gastrointestinal manifestations are abdominal pain, diarrhea or malabsorption. The lack of well-defined diagnostic criteria and patchy microscopic involvement make diagnosis difficult. We report the case of a 44-year-old male with chronic diarrhea. After performing multiple studies, he was diagnosed of eosinophilic enterocolitis, with a suitable response to corticosteroids.
Assuntos
Enterite , Enterocolite , Eosinofilia , Gastrite , Adulto , Diarreia/etiologia , Enterocolite/complicações , Eosinofilia/complicações , Gastrite/complicações , Gastrite/diagnóstico , Humanos , MasculinoRESUMO
Acute pancreatitis is one of the main reasons for hospitalization, with an increasing incidence and associated non-negligible morbidity and mortality. Its most common causes are alcohol and gallstones, and medications are a rare cause. The pathogenesis of acute drug pancreatitis is not yet known exactly and the diagnosis is based on the evident temporal relationship, having excluded the rest of the possible known causes of acute pancreatitis. We present the case of a 71-year-old patient diagnosed with IgG multiple myeloma treated with the Daratumumab, Bortezomib and Dexamethasone regimen. After Bortezomib administration, he developed epigastric pain and elevated pancreatic enzymes in the range of acute pancreatitis. After ruling out common causes, the diagnosis of acute pancreatitis caused by Bortezomib was reached, which presents a favorable rapid evolution after its elimination.
