乳糜胸：一种归因于使用达沙替尼的并发症。
Chylothorax: complication attributed to dasatinib use.
作者信息
Al-Abcha Abdullah, Iftikhar Mian Harris, Abu Rous Fawzi, Laird-Fick Heather
机构信息
Internal Medicine, Michigan State University, East Lansing, Michigan, USA
Sleep Medicine, Washington University, St Louis, Missouri, USA.
出版信息
BMJ Case Rep. 2019 Dec 16;12(12):e231653. doi: 10.1136/bcr-2019-231653.
A 63-year-old woman with a medical history of chronic myelogenous leukaemia treated with dasatinib, chronic obstructive pulmonary disease and heart failure with preserved ejection fraction presented with difficulty in breathing. Chest X-ray showed large right-sided pleural effusion, which was confirmed on a CT angiogram of the chest. Echocardiogram showed an ejection fraction of 61% with moderate to severely dilated right ventricle and right ventricular systolic pressure of 60 mm Hg. Diagnostic and therapeutic thoracentesis was performed, and 2.2 L of pleural fluid was removed. Pleural fluid analysis was consistent with chylothorax. Significant symptomatic improvement was noted after thoracentesis. In the absence of an alternate explanation, chylothorax was attributed to dasatinib, which was switched to nilotinib. This resulted in resolution of her pleural effusions.
一名63岁女性，有慢性髓性白血病病史，曾接受达沙替尼治疗，同时患有慢性阻塞性肺疾病和射血分数保留的心力衰竭，现出现呼吸困难。胸部X线显示右侧大量胸腔积液，胸部CT血管造影证实了这一情况。超声心动图显示射血分数为61%，右心室中度至重度扩张，右心室收缩压为60 mmHg。进行了诊断性和治疗性胸腔穿刺术，抽出了2.2 L胸腔积液。胸腔积液分析结果与乳糜胸相符。胸腔穿刺术后症状明显改善。在没有其他解释的情况下，乳糜胸归因于达沙替尼，遂将其换为尼洛替尼。这使得她的胸腔积液得以消退。
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