• PDF / 170,480 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 72 Downloads / 150 Views

DOWNLOAD

REPORT

---

1 S

Thrombocytopenia, diarrhoea and nausea: case report A 56-year-old woman developed diarrhoea and nausea during treatment with colchicine for intestinal Behcet’s-like disease accompanied with myelodysplastic syndrome involving trisomy 8. Further, she developed thrombocytopenia following treatment with azacitidine. The woman had a history of simple oral ulcer, lower abdominal pain and recurrent high-grade fever since April 2016. She was diagnosed with aplastic anaemia at the age of 15 years. In February 2017, she was admitted with the same symptoms, based on findings she was diagnosed with myelodysplastic syndrome involving trisomy 8. She received treatment with unspecified antibiotics, and immediately her oral ulcer improved. But, the abdominal pain and fever recurred. Thus, she was again admitted in April 2017. Findings revealed multiple oval ulcers in various sites of colon, terminal ileum, duodenum and jejunum. Based on further findings, she was diagnosed with intestinal Behcet’s-like disease. She was also diagnosed with atypical familial mediterranean fever. She started receiving colchicine 1.0 mg/day [route not stated]. But, she could not tolerate the treatment due to development of treatment related diarrhoea and nausea [durations of treatments to reactions onsets and outcomes not stated]. The woman discontinued the colchicine and started receiving IV azacitidine 90 mg/day for 7 days of a 4 week cycle. Following the first cycle of treatment, she had improvement in both small intestinal lesions and colonic lesions. But, she developed a moderate grade thrombocytopenia as an adverse event to the azacitidine. However, she recovered immediately. Later, she was discharged from the hospital in May 2017. She continued the azacitidine at 45 mg/day for 5 days of a 4 week cycle. Prior to fourth cycle, she had abdominal pain and high grade fever. For that she received gammaglobulin, multiple unspecified antibiotics, hydrocortisone and prednisolone. The abdominal pain and fever diminished. The azacitidine treatment was continued. Following the eighth cycle of azacitidine therapy findings revealed remission of all ulcer lesions. She had endoscopic remission with histological improvement and did not develop abdominal pain and fever again. She completed 23 cycles of azacitidine therapy and remained in endoscopic remission for more than 2 years. Tanaka N, et al. Long-term maintenance of the mucosal healing induced by azacitidine therapy in a patient with intestinal Behcet's-like disease accompanied with myelodysplastic syndrome involving trisomy 8. Immunological Medicine 42: 135-141, No. 3, Sep 2019. Available from: URL: http:// 803499279 doi.org/10.1080/25785826.2019.1687251

0114-9954/20/1820-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

Reactions 5 Sep 2020 No. 1820