Paclitaxel
- PDF / 170,764 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 42 Downloads / 135 Views
1
S
Infusion related hypersensitivity reaction and generalised tonic-clonic seizure: case report A 60-year-old woman developed infusion related hypersensitivity reaction and generalised tonic-clonic seizure during treatment with paclitaxel for squamous cell carcinoma of the left lung. The woman, who was recently diagnosed with stage IIIA squamous cell carcinoma of the left lung was admitted due to productive cough of 4 weeks duration and had received treatment with piperacillin/tazobactam. She was found to have Pseudomonas aeruginosa infection, which improved gradually. Then, on day 11 of hospitalisation, she started receiving inpatient chemotherapy with paclitaxel infusion [dosage not stated]. Two hours after starting the infusion, she complained of hot flashes, shortness of breath and squeezing sensation in the middle of her chest. Her oxygen saturation dropped to 74% and her temperature was 37.1°C, heart rate was 84 beats per minute, respiratory rate was 27 cycles per minute and BP was 109/72mm Hg. This was followed by generalised onset tonicclonic seizure, which lasted approximately 90 seconds with associated urinary incontinence and post-ictal confusion. The woman’s paclitaxel infusion was stopped immediately. She started receiving supplemental oxygen via nasal cannula, following which her oxygen saturation improved. Based on neurology consultation, a diagnosis of generalised onset tonicclonic seizure with no other aetiologies identified except for hypersensitivity reaction secondary to paclitaxel infusion was considered. Electroencephalogram performed 48 hours after the seizure episode was normal. She did not experience any other seizure episode during her admission. A diagnosis of paclitaxel-induced seizure likely from a hypersensitivity reaction to paclitaxel was made based on the WHO-UMC causality assessment with a probable/likely causality. She was discharged with plan to commence outpatient radiotherapy and oncology outpatient follow-up to decide other chemotherapy options as she had refused additional treatment with paclitaxel. Author comment: "In our patient, a diagnosis of chemotherapy‐induced seizure likely from a hypersensitivity reaction to paclitaxel was made considering the temporality of paclitaxel infusion to the seizure episode after excluding other plausible causes including brain metastasis, hypoglycaemia and electrolyte imbalances. (WHO‐UMC causality assessment system‐Probable/Likely causality)." Ajiboye O, et al. A rare case of generalized tonic-clonic seizure related to paclitaxel infusion. Journal of Clinical Pharmacy and Therapeutics 44: 974-976, No. 6, Dec 2019. Available from: URL: http://doi.org/10.1111/jcpt.13027 803440602 USA
0114-9954/19/1784-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 21 Dec 2019 No. 1784
Data Loading...
