Perel-Winkler Alexandra, Belokovskaya Regina, Amigues Isabelle, Larusso Melissa, Hussain Nazia
Department of Medicine, St. Luke's-Roosevelt Hospital Center, and Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10025, USA.
Division of Rheumatology, Department of Medicine, St. Luke's-Roosevelt Hospital Center, and Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10025, USA.
Case Rep Rheumatol. 2015;2015:795242. doi: 10.1155/2015/795242. Epub 2015 Jul 16.
In phase I and II trials taxane chemotherapeutic agents reported side effects, including myelosuppression, peripheral edema, and fluid retention. With further use of these agents, studies in the late 1980s and early 1990s began to report peripheral neuropathy and proximal muscle weakness as common complaints, the later with unexplained pathophysiology. We report a 65-year-old Hispanic woman with estrogen receptor (ER) and progesterone receptor (PR) positive invasive ductal breast carcinoma who presented with right thigh pain and swelling eight days after her third infusion of docetaxel (a taxane chemotherapeutic) and cyclophosphamide. Laboratory findings were notable for elevation in creatine phosphokinase (CPK), aldolase, and erythrocyte sedimentation rate (ESR); a magnetic resonance imaging (MRI) of her lower extremities showed evidence of bilateral muscle edema involving the anterior compartment muscles of the thighs. A workup to rule out other causes of myositis was negative. Docetaxel was not reintroduced and the patient improved with corticosteroids. Since 2005 this is, to our knowledge, the fifth reported case of docetaxel related inflammatory myositis. Taxanes have been noted to cause disabling but transient arthralgias and myalgias; it is important to consider the possibility of inflammatory myopathy as a possible complication in patients undergoing treatment with these agents.
在I期和II期试验中，紫杉烷类化疗药物报告了包括骨髓抑制、外周水肿和液体潴留在内的副作用。随着这些药物的进一步使用，20世纪80年代末和90年代初的研究开始报告外周神经病变和近端肌肉无力是常见的主诉，后者的病理生理学原因不明。我们报告了一名65岁的西班牙裔女性，她患有雌激素受体（ER）和孕激素受体（PR）阳性的浸润性导管乳腺癌，在第三次输注多西他赛（一种紫杉烷类化疗药物）和环磷酰胺八天后出现右大腿疼痛和肿胀。实验室检查结果显示肌酸磷酸激酶（CPK）、醛缩酶和红细胞沉降率（ESR）升高；她下肢的磁共振成像（MRI）显示双侧大腿前侧肌群存在肌肉水肿的迹象。排除其他肌炎病因的检查结果为阴性。未重新使用多西他赛，患者使用皮质类固醇后病情好转。据我们所知，自2005年以来，这是第五例报告的与多西他赛相关的炎性肌炎病例。紫杉烷类药物已被注意到会引起致残但短暂的关节痛和肌痛；在接受这些药物治疗的患者中，将炎性肌病视为可能的并发症是很重要的。
