McGonegal Caitlin E, Baskar Sujatha
Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Internal Medicine, AdventHealth Waterman, Tavares, USA.
Cureus. 2024 Sep 2;16(9):e68479. doi: 10.7759/cureus.68479. eCollection 2024 Sep.
Dasatinib, a BCR-ABL tyrosine kinase inhibitor, is used in the management of Philadelphia-positive chronic myeloid leukemia (CML). Several adverse complications of this targeted immunotherapy have been reported. This case report focuses on a 79-year-old female who presented with acute dyspnea and generalized chest pressure while undergoing management with this specific tyrosine kinase inhibitor. Bilateral chylothorax was diagnosed with the aid of imaging, laboratory studies, and diagnostic thoracentesis. No other risk factors, including trauma, lung malignancies, or congenital anomalies, were detected in this patient. Since no other etiologies for the development of chylothorax were identified, it was concluded that dasatinib therapy was the inciting factor. Dasatinib was discontinued and bosutinib was initiated. A low-fat diet was prescribed, which the patient was amenable to. Six months later, the patient remained stable with no recurrence of chylothorax. The mechanism of dasatinib-induced chylothorax is currently under investigation. The purpose of this report is to raise awareness about dasatinib-induced chylothorax, aid in identifying predisposing risk factors, and enhance understanding of the proper management of this rare complication.
达沙替尼是一种BCR-ABL酪氨酸激酶抑制剂，用于治疗费城染色体阳性的慢性髓性白血病（CML）。已有报道称这种靶向免疫疗法存在多种不良并发症。本病例报告聚焦于一名79岁女性，她在接受这种特定酪氨酸激酶抑制剂治疗期间出现急性呼吸困难和胸部广泛性压迫感。借助影像学、实验室检查和诊断性胸腔穿刺术诊断为双侧乳糜胸。该患者未检测到其他危险因素，包括外伤、肺部恶性肿瘤或先天性异常。由于未发现导致乳糜胸的其他病因，得出结论认为达沙替尼治疗是诱发因素。停用达沙替尼并开始使用博舒替尼。规定了低脂饮食，患者对此表示接受。六个月后，患者病情稳定，乳糜胸未复发。目前正在研究达沙替尼诱发乳糜胸的机制。本报告的目的是提高对达沙替尼诱发乳糜胸的认识，帮助识别易感危险因素，并增进对这种罕见并发症正确管理的理解。
