Acute pericarditis and pleural effusion complicating cytarabine chemotherapy.

Abstract

BACKGROUND:

Pericarditis is a rare but possibly severe complication of treatment of acute leukemia with cytarabine.

CASE REPORT:

We report a possibly cytarabine-induced acute pericarditis and pleuritis with a rapid onset. A patient with acute myelomonocytic leukemia developed an isolated pericarditis 3 weeks after the first course of chemotherapy with cytarabine and idarubicin. The second course of chemotherapy with cytarabine and amsacrine was started after clinical improvement; 3 days later an acute pericarditis with a large pericardial effusion accompanied by a left pleural effusion developed. A pericardio- and pleuracentesis was performed and the symptoms improved rapidly without reaccumulation of the fluid. The third course of chemotherapy with mitoxantrone and etoposide was completed without further cardiopulmonary complications.

CONCLUSION:

The differential diagnosis of pericarditis in the setting of chemotherapy with cytarabine should include cytarabine- induced pericarditis. The pathogenesis remains unclear, directly toxic and immunological mechanisms are suggested. Severe progression with massive pericardial effusion necessitating risky pericardiocentesis can occur and therefore a therapy with high-dose corticosteroids should be considered early.

• Authors: A Gähler, F Hitz, U Hess, T Cerny
• Journal: Onkologie (Onkologie) Vol. 26 Issue 4 Pg. 348-50 (Aug 2003) ISSN: 0378-584X [Print] Switzerland
• PMID: 12972701 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2003 S. Karger GmbH, Freiburg

Chemical References

• Antimetabolites, Antineoplastic
• Cytarabine

Topics

• Acute Disease
• Antimetabolites, Antineoplastic (adverse effects, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Cytarabine (adverse effects, therapeutic use)
• Humans
• Leukemia, Myelomonocytic, Acute (drug therapy)
• Male
• Middle Aged
• Pericarditis (chemically induced, diagnosis)
• Pleural Effusion (chemically induced, diagnosis)
• Recurrence