5-羟色胺综合征使异环磷酰胺神经毒性用亚甲蓝治疗复杂化。
Serotonin Syndrome Complicating Treatment of Ifosfamide Neurotoxicity With Methylene Blue.
作者信息
Snyder Matthew, Gangadhara Suhas, Brohl Andrew S, Ludlow Steven, Nanjappa Sowmya
机构信息
1 Department of Pharmacy, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
2 Department of Neurology, University of South Florida, Tampa, FL, USA.
出版信息
Cancer Control. 2017 Oct-Dec;24(5):1073274817729070. doi: 10.1177/1073274817729070.
Methylene blue is a widely used treatment for ifosfamide neurotoxicity. We present a case of severe encephalopathy complicating ifosfamide-based therapy for recurrent retroperitoneal leiomyosarcoma. After treatment with methylene blue, the patient experienced clinical decompensation and was diagnosed with serotonin syndrome based on a constellation of clinical findings. Withdrawal of methylene blue and other serotonergic medications led to clinical stabilization and ultimately neurological recovery. Our case highlights the challenge of diagnosing serotonin syndrome in the face of preexisting ifosfamide neurotoxicity, as there is significant clinical overlap between these 2 syndromes. Practitioners must remain vigilant of this potential life-threatening complication in this vulnerable population.
亚甲蓝是一种广泛用于治疗异环磷酰胺神经毒性的药物。我们报告了一例因复发性腹膜后平滑肌肉瘤接受基于异环磷酰胺的治疗而并发严重脑病的病例。在用亚甲蓝治疗后，患者出现临床失代偿，并根据一系列临床症状被诊断为血清素综合征。停用亚甲蓝和其他血清素能药物后，患者临床症状稳定，最终神经功能恢复。我们的病例突出了在存在异环磷酰胺神经毒性的情况下诊断血清素综合征的挑战，因为这两种综合征在临床上有显著重叠。从业者必须对这一易发生危险的人群中这种潜在的危及生命的并发症保持警惕。
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