Pneumatosis intestinalis induced by targeted therapy

Case presentation A middle aged woman presented to the emergency department with vomiting and diarrhoea for 5 days. She was diagnosed as stage IV lung adenocarcinoma with EGFR mutation. Two weeks ago, she just started a combination of erlotinib and crizotinib based on the discovery of MET amplification after failure of afatinib and subsequent chemotherapy treatment. At the emergency department, she appeared with acute ill-looking, low-grade fever (37.6°C), hypotension (SBP/DBP 87/57 mm Hg) and tachycardia (140 bpm). Physical examination showed a soft and mildly distended abdomen with hypoactive bowel sounds and no tenderness or rebounding pain. Laboratory tests revealed elevated C reactive protein (14.54 mg/dL) and lactate acidosis (77.2 mg/dL). A plain abdominal radiograph disclosed diffuse intramural air (figure 1A). CT (figure 1B) confirmed the diagnosis of pneumatosis intestinalis (PI), extending from jejunum to ileum. Portal vein gas was noted as well. Erlotinib and crizotinib were both discontinued. The...

Source: Postgraduate Medical Journal - December 15, 2021 Category: General Medicine Authors: Chang, C.-J., Shen, C.-I., Wu, C.-L., Chiu, C.-H. Tags: Adverse drug reactions Source Type: research