Rasul Taha F, Motoa Gabriel, Flowers Robert C
Internal Medicine, University of Miami Miller School of Medicine, Miami, USA.
Internal Medicine, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, USA.
Cureus. 2022 Apr 7;14(4):e23906. doi: 10.7759/cureus.23906. eCollection 2022 Apr.
Fluid accumulation in the form of pleural effusions and ascites may be attributed to a single etiology. Diagnosis depends on a thorough clinical history as well as fluid analysis. We present the case of a 60-year-old man with chronic myeloid leukemia (CML) on dasatinib, recent right-sided ischemic stroke, alcohol-associated liver disease, cocaine and alcohol use disorders in early remission, and hypertension who presented with subacute-onset of bilateral pleural effusions and ascites. Pleural fluid analysis showed an exudative effusion, while ascitic fluid analysis showed a transudative collection. After an extensive workup, the bilateral effusions were attributed to dasatinib therapy, which was also suspected to play an unclear role in the worsening ascites. Although peripheral edema and pleural effusions are well-recognized and common side effects of tyrosine kinase inhibitors (TKIs), this case represents the first description of a patient presenting with bilateral TKI-induced pleural effusions as well as concomitant ascites of unclear origin.
以胸腔积液和腹水形式出现的液体蓄积可能归因于单一病因。诊断取决于详尽的临床病史以及液体分析。我们报告一例60岁男性病例，该患者患有慢性髓性白血病（CML），正在接受达沙替尼治疗，近期发生右侧缺血性卒中，有酒精相关性肝病，可卡因和酒精使用障碍处于早期缓解期，还有高血压，出现双侧胸腔积液和腹水亚急性发作。胸腔积液分析显示为渗出液，而腹水分析显示为漏出液。经过广泛检查，双侧胸腔积液归因于达沙替尼治疗，其在腹水加重中也被怀疑起到不明作用。尽管外周水肿和胸腔积液是酪氨酸激酶抑制剂（TKIs）公认的常见副作用，但该病例是首例描述患者出现双侧TKI诱导的胸腔积液以及不明来源的伴随腹水。
