Department of Internal Medicine, Division of Hematology, Faculty of Medicine, 37502Akdeniz University, Antalya, Turkey.
Department of Internal Medicine, Faculty of Medicine, 37502Akdeniz University, Antalya, Turkey.
J Oncol Pharm Pract. 2022 Mar;28(2):500-503. doi: 10.1177/10781552211049728. Epub 2021 Oct 12.
Hypomethylating agents have confirmed efficacy for myelodysplastic syndrome and acute myeloid leukemia and are widely used. Although arthralgia is common side effect associated with hypomethylating agents, arthritis has not been reported previously.
We present the first recorded patient with arthritis after azacitidine treatment. The patient we presented here had severe cytopenias requiring transfusion with erythrocyte and platelet suspensions, and a complete hematological response was obtained for myelodysplastic syndrome after three cycles of azacitidine (AZA) treatment. However, interestingly, after each AZA treatment cycle, the patient had recurrent attacks of arthritis.
The episodes of arthritis were possibly acute flares of pre-existing crystal-induced arthritis, as exhibited with azacitidine treatments and were managed effectively with nonsteroidal anti-inflammatory drugs.
Because it is a rare condition, clinicians should not overlook AZA as a possible cause of arthritis exacerbations when arthritis of unknown etiology develops in patients treated with AZA.
去甲基化药物已被证实对骨髓增生异常综合征和急性髓系白血病有效，且被广泛应用。虽然关节痛是去甲基化药物常见的副作用，但之前并未有报道称其与关节炎有关。
我们报告了首例阿扎胞苷治疗后发生关节炎的患者。我们报告的这名患者因严重的血细胞减少症需要输注红细胞和血小板悬液，在接受三个周期的阿扎胞苷（AZA）治疗后，骨髓增生异常综合征获得完全血液学缓解。然而，有趣的是，在每个 AZA 治疗周期后，患者都会出现关节炎反复发作。
关节炎发作可能是晶体诱导性关节炎的急性发作，如 AZA 治疗所表现的那样，使用非甾体抗炎药可有效治疗。
由于这种情况较为罕见，当接受 AZA 治疗的患者出现不明病因的关节炎时，临床医生不应忽视 AZA 可能是关节炎恶化的原因。
