Cardiotoxicity of cyclophosphamide in the treatment of microscopic polyangiitis – case report
Authors:
A. Jansová 1; M. Podhola 2; H. Medková 1; J. Řezáčová 3; T. Soukup 1
Authors‘ workplace:
Fingerlandův ústav patologie LF UK a FN, Hradec Králové
2; Radiologická klinika LF UK a FN, Hradec Králové
3
Published in:
Čes. Revmatol., 28, 2020, No. 4, p. 240-246.
Category:
Case Report
Overview
Introduction: Cyclophosphamide (CPA) is a drug from the group of alkylating cytostatics with significant immunosuppressive effects. These are used in the treatment of severe organ manifestations in necrotizing vasculitis and diffuse connective tissue diseases. The administration of CPA may be complicated by its side effects (AE). We are able to predict and influence some, but we cannot predict the occurrence of rare AE. One of them is cardiac toxicity.
Case description: This is a case report of a 61-year-old woman with microscopic polyangiitis (MPA) initially manifested by a severe pulmonary-renal syndrome. Following a good response to induction therapy, acute left heart failure developed over time following CPA administration. After excluding other causes of acute heart failure, the cause of CPA toxicity was determined, and treatment was changed to rituximab.
Conclusion: Deterioration in a patient with vasculitis treated with CPA is a complex differential diagnostic problem. It may be a manifestation of an underlying or concurrent disease or the toxicity of the administered treatment. In case of toxic effects of CPA, rituximab may be an alternative medication
Keywords:
Cyclophosphamide – cardiotoxicity – heart failure – rituximab – vasculitis
Sources
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Labels
Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
2020 Issue 4
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