Jirasek Matthew A, Herrington Jon D
Department of Pharmacy, Scott & White Memorial Hospital, Baylor Scott & White Health, Temple, TX, USA.
Department of Pharmacy, Scott & White Memorial Hospital, Baylor Scott & White Health, Temple, TX, USA Department of Medicine, Health Science Center, Texas A&M University, Temple, TX, USA
J Oncol Pharm Pract. 2016 Dec;22(6):795-800. doi: 10.1177/1078155215607090. Epub 2015 Sep 28.
Cytarabine syndrome is a rare clinical condition characterized by fever, malaise, myalgia, arthralgia, and/or rash that occurs after receipt of cytarabine. Our patient developed fever, malaise, and diffuse body pain shortly following cytarabine initiation despite receiving prophylactic dexamethasone. The patient's discomfort was treated with intravenous morphine and her other symptoms were controlled with a higher dose of dexamethasone. Although the exact cause is not fully understood, cytarabine syndrome is hypothesized to be an immune-mediated response following cytarabine-induced apoptosis that results in a rapid increase in proinflammatory cytokines. While there is no standard therapy for cytarabine syndrome, corticosteroids appear to play a role in the treatment and prevention of the condition by suppressing the proinflammatory response. Since our case describes the development of cytarabine syndrome despite dexamethasone, clinicians should monitor for this adverse event if patients begin exhibiting characteristics of this syndrome.
阿糖胞苷综合征是一种罕见的临床病症，其特征为在接受阿糖胞苷后出现发热、不适、肌痛、关节痛和/或皮疹。尽管我们的患者在开始使用阿糖胞苷时接受了预防性地塞米松治疗，但仍在用药后不久出现了发热、不适和全身弥漫性疼痛。患者的不适通过静脉注射吗啡进行治疗，其他症状则通过更高剂量的地塞米松得到控制。虽然确切病因尚未完全明确，但推测阿糖胞苷综合征是阿糖胞苷诱导细胞凋亡后引发的免疫介导反应，导致促炎细胞因子迅速增加。虽然阿糖胞苷综合征尚无标准治疗方法，但皮质类固醇似乎通过抑制促炎反应在该病症的治疗和预防中发挥作用。由于我们的病例描述了尽管使用了地塞米松仍发生阿糖胞苷综合征的情况，因此如果患者开始表现出该综合征的特征，临床医生应监测这一不良事件。
