Nakano Ryota, Momo Kenji, Matsuzaki Airi, Sakai Akiko, Uchikura Takeshi, Tanaka Katsumi, Numazawa Satoshi, Sasaki Tadanori
Department of Pharmacy Izumi Memorial Hospital Adachi-ku Japan.
Department of Pharmacy Showa University Hospital Shinagawa-ku Japan.
Clin Case Rep. 2022 Apr 21;10(4):e05718. doi: 10.1002/ccr3.5718. eCollection 2022 Apr.
Most hypotension during chemotherapy is caused by an allergic mechanism. Conversely, non-allergic hypotension due to chemotherapy is rare. In this case report, we present a patient who suffered severe hypotension followed by the administration of irinotecan-based chemotherapy and some supportive care such as steroids for preventing emesis. A 71-year-old man with hypertension was diagnosed with stage IV small cell lung cancer (sT1cN3M0). Severe hypotension occurred in the patient after every administration of chemotherapy. Finally, he was able to receive all four courses of chemotherapy as planned along with the medical staff's support care. This case provides that a regimen that contained irinotecan and steroid could cause hypotension and the mechanism is partially explained by inhibiting choline esterase and adrenal insufficiency. We should be careful about non-allergic hypotension when we administer irinotecan-based chemotherapy.
化疗期间的大多数低血压是由过敏机制引起的。相反，化疗引起的非过敏性低血压很少见。在本病例报告中，我们介绍了一名患者，在接受基于伊立替康的化疗及一些支持性治疗（如用于预防呕吐的类固醇）后出现严重低血压。一名患有高血压的71岁男性被诊断为IV期小细胞肺癌（sT1cN3M0）。该患者每次化疗后均出现严重低血压。最后，在医护人员的支持治疗下，他得以按计划接受了全部四个疗程的化疗。本病例表明，包含伊立替康和类固醇的治疗方案可能会导致低血压，其机制部分可通过抑制胆碱酯酶和肾上腺功能不全来解释。在给予基于伊立替康的化疗时，我们应注意非过敏性低血压。
