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Various toxicities: case report An approximately 61-year-old man developed drug-dependence, pancytopenia, muscle atrophy, full moon face, muscle weakness, muscle soreness, fatigue, recurrent fever and myelodysplastic syndrome (MDS) during treatment with prednisone for vasculitis and also exhibited rebound of vasculitis following prednisone dose reduction. Subsequently, he developed myelosuppression and exhibited treatment failure during treatment with decitabine for vasculitis [durations of treatments to reactions onsets not stated; not all outcomes stated]. The man presented to a clinic with chief complaints of fever and erythema in both legs along with arthralgia in the hip, knee and ankle joints in July 2014 (at the age of 60 years). Following further investigations, he was diagnosed with vasculitis. He started receiving oral prednisone 60mg daily and cyclophosphamide with significant improvement. Following decrease in prednisone dose to 25 mg/day, he developed a fever with red rashes around his limbs, trunk and slight protrusion on the skin surface in July 2015, indicating rebound of vasculitis. The man’s blood test showed haemoglobin (Hb) of 82 g/L and a platelet count of 31 × 109/L. Subsequent bone marrow smear revealed dysplasia in both neutrophils and erythroid cells, and the increased proportion of erythroid cell to 39% with megaloblastoid nuclei and multinucleation. A karyotype analysis revealed 44–45, XY, +8[CP4]/46, XY [6], and MDS FISH revealed Csp (No. 8 centromere) (gain) accounting for 15%. He was diagnosed with MDS. Therefore, he started receiving ciclosporine, levamisole and erythropoietin. He continued to receive oral prednisone at dose of 40mg daily for systemic vasculitis. In November 2015, he developed drug dependence during prednisone therapy and exhibited fever again with fatigue and myalgia. Therefore, he again visited to the clinic. Subsequent blood test showed pancytopenia with WBC of 2.5 × 109/L, neutrophil count (NE) of 1.75 × 109/L, Hb levels of 57 g/L and a platelet count (PLT) of 14 × 109/L. His pancytopenia was attributed to prednisone. A bone marrow smear demonstrated multilineage dysplasia, with neutrophil dysplasia accounting for 9% of dysplasia and erythroid dysplasia accounting for 4% of dysplasia. A repeat karyotype analysis revealed 48, XY, t(3;12) (q27;q22), +8, +12. Gene mutation screening showed a 10-11-translocation 2 (TET2) mutation (site: 4612 4629 del). Therefore, he was diagnosed with MDS-unclassified (MDS-U). Following use of prednisone for more than 1 year, he also developed prednisone-related muscle atrophy and full moon face. A muscle weakness and soreness along with fatigue and recurrent fever resulted in his poor physical condition (KPS 40 scores). Therefore, he was initiated with ultra-low-dose decitabine 7 mg/m2 daily [route not stated] consecutively for 5 days on a 28 day cycle. At that time, he continued to receive oral prednisone 40mg daily for vasculitis. The prednisone dosage was reduced by 5mg per week. During decitabine first cycle, he developed gr