Bortezomib
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Absolute constipation and paralytic ileus: case report A 68-year-old man developed absolute constipation and paralytic ileus during treatment with bortezomib for multiple myeloma. The man was hospitalised due to the diagnosis of multiple myeloma (ISS-Stage-III, light chain disease). At that time, he had decreased serum potassium levels and deranged renal function. Therefore, he received supportive care with unspecified renal safe antibiotics, IV fluid and IV potassium, which showed significant improvement. Further, he started receiving SC bortezomib weekly [dose not stated], thalidomide and dexamethasone on day 5 of the admission. Concurrently, he also received aspirin. He received first dose of bortezomib on 18 March 2020. On day 5 after the second bortezomib dose, he reported abdominal distension with decreased frequency of defecation followed by absolute constipation over a period of two days. During this period, he was afebrile with normal electrolytes. The thoraco-abdominal X-ray (PA view) revealed grossly distended large bowel loops along with lower lung zone infiltrates and multiple osteolytic lesions in ribs. Based on the clinical picture, paralytic ileus was diagnosed. The man was treated with unspecified proton pump inhibitors. Simultaneously, enema and flatus tube were placed to manage gastrointestinal symptoms. However, his complaints persisted. Therefore, bortezomib was discontinued from third dose onwards. Gradually, his symptoms improved over one week. Further, he received lenalidomidea and dexamethasone on 8 April 2020 for further management of multiple myeloma. After 2 weeks of lenalidomide initiation, he expired during the hospitalisation due to hospital-acquired pneumonia. Verma SP, et al. Bortezomib induced paralytic ileus: Are we aware?. Journal of Clinical and Diagnostic Research 14: XD01-XD02, No. 8, Aug 2020. Available from: URL: 803515996 http://doi.org/10.7860/JCDR/2020/45267.13944
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Reactions 21 Nov 2020 No. 1831
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