Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
BMJ Case Rep. 2020 Oct 29;13(10):e236349. doi: 10.1136/bcr-2020-236349.
We present a case of azacitidine-induced pneumonitis which is a rare adverse drug reaction and reported in less than 0.1% of cases. Common side effects of azacitidine are weakness, nausea, vomiting, constipation, injection site reactions, insomnia, among others. Our patient received azacitidine to treat her acute myeloid leukaemia and began to develop shortness of breath which progressed to dyspnoea at rest after completing a 7-day course of azacitidine and venetoclax. Initial chest X-ray revealed severe airspace disease for which the patient began receiving broad spectrum antibiotics, antifungals and antivirals therapy. Although infectious workup revealed invasive aspergillosis she did not clinically and radiologically improve despite being on isavuconazole until high-dose glucocorticoids were initiated. This case illustrates the importance of recognising and understanding the potential side effects of azacitidine and other chemotherapy agents as some adverse drug reactions can be life-threatening.
我们报告了一例阿扎胞苷引起的肺炎，这是一种罕见的药物不良反应，不到 0.1%的病例有报道。阿扎胞苷的常见副作用包括乏力、恶心、呕吐、便秘、注射部位反应、失眠等。我们的患者接受阿扎胞苷治疗急性髓系白血病，在完成 7 天阿扎胞苷和 venetoclax 治疗后开始出现呼吸急促，进展为静息时呼吸困难。初始胸片显示严重的气腔疾病，为此患者开始接受广谱抗生素、抗真菌和抗病毒治疗。尽管感染性检查显示侵袭性曲霉菌病，但即使使用伊曲康唑，患者的临床和影像学也没有改善，直到开始使用大剂量糖皮质激素。本例说明了识别和理解阿扎胞苷和其他化疗药物潜在副作用的重要性，因为一些药物不良反应可能危及生命。
