内容紹介
A Case of Chronic Myelogenous Leukemia That Developed Fibrous Pericarditis Owing to Nilotinib Use
Summary
A 64-year-old man was diagnosed with chronic-phase chronic myelogenous leukemia(CML)in May 2009. He was treated with imatinib and achieved complete cytogenetic response(CCyR)in 2 months. After 4 months of treatment, he developed interstitial pneumonia and became intolerant to imatinib. He was then switched to nilotinib from October of the same year. In June 2013, he was diagnosed with drug-induced pericarditis resulting from nilotinib use, and thus, nilotinib was discontinued. Subsequently, he was followed up without specific treatment for CML. In January 2014, he was admitted to the Dept. of Cardiovascular, Renal and Metabolic Medicine at our hospital because of heart failure. After examinations of cardiac function, he was diagnosed with constrictive pericarditis. Therefore, pericardiolysis was performed by the Dept. of Cardiovascular Surgery at our hospital. Pathologic findings showed hyaline-like fibrous tissue proliferation in the pericardium, which was diagnosed as fibrous pericarditis induced by nilotinib. We report a case of chronic myelogenous leukemia that developed fibrous pericarditis owing to nilotinib use.
要旨
症例は64歳,男性。2009年5月に慢性骨髄性白血病(chronic myelogenous leukemia: CML)慢性期と診断,イマチニブで治療開始され,2か月でcomplete cytogenetic response(CCyR)が得られた。2009年9月にイマチニブによる間質性肺炎を発症し,10月からニロチニブに変更された。2013年6月にニロチニブによる薬剤性心膜炎と診断され,同薬剤を中止した。慢性骨髄性白血病に対して無治療経過観察をしていたが,2014年1月に心不全にて当院循環器・腎臓・代謝内分泌内科学講座へ入院となった。精査にて収縮性心膜炎の診断となり,当院心臓血管外科にて心膜剥離術が施行された。病理所見では心膜に硝子様の線維性組織増生を認め,ニロチニブによる線維性心膜炎と診断した。今回,ニロチニブによる線維性心膜炎を発症した1例を経験したので報告する。
目次
Summary
A 64-year-old man was diagnosed with chronic-phase chronic myelogenous leukemia(CML)in May 2009. He was treated with imatinib and achieved complete cytogenetic response(CCyR)in 2 months. After 4 months of treatment, he developed interstitial pneumonia and became intolerant to imatinib. He was then switched to nilotinib from October of the same year. In June 2013, he was diagnosed with drug-induced pericarditis resulting from nilotinib use, and thus, nilotinib was discontinued. Subsequently, he was followed up without specific treatment for CML. In January 2014, he was admitted to the Dept. of Cardiovascular, Renal and Metabolic Medicine at our hospital because of heart failure. After examinations of cardiac function, he was diagnosed with constrictive pericarditis. Therefore, pericardiolysis was performed by the Dept. of Cardiovascular Surgery at our hospital. Pathologic findings showed hyaline-like fibrous tissue proliferation in the pericardium, which was diagnosed as fibrous pericarditis induced by nilotinib. We report a case of chronic myelogenous leukemia that developed fibrous pericarditis owing to nilotinib use.
要旨
症例は64歳,男性。2009年5月に慢性骨髄性白血病(chronic myelogenous leukemia: CML)慢性期と診断,イマチニブで治療開始され,2か月でcomplete cytogenetic response(CCyR)が得られた。2009年9月にイマチニブによる間質性肺炎を発症し,10月からニロチニブに変更された。2013年6月にニロチニブによる薬剤性心膜炎と診断され,同薬剤を中止した。慢性骨髄性白血病に対して無治療経過観察をしていたが,2014年1月に心不全にて当院循環器・腎臓・代謝内分泌内科学講座へ入院となった。精査にて収縮性心膜炎の診断となり,当院心臓血管外科にて心膜剥離術が施行された。病理所見では心膜に硝子様の線維性組織増生を認め,ニロチニブによる線維性心膜炎と診断した。今回,ニロチニブによる線維性心膜炎を発症した1例を経験したので報告する。