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Gemcitabine induced digital ischaemia and necrosis
Author(s) -
HOLSTEIN A.,
BÄTGE R.,
EGBERTS E.H.
Publication year - 2010
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/j.1365-2354.2008.01057.x
Subject(s) - medicine , iloprost , gemcitabine , ischemia , carboplatin , adverse effect , chemotherapy , anesthesia , surgery , prostacyclin , cisplatin
HOLSTEIN A., BÄTGE R. & EGBERTS E.‐H. (2010) European Journal of Cancer Care 19 , 408–409
Gemcitabine induced digital ischaemia and necrosis A 70‐year‐old woman presented with a 7‐day history of severe pain, paresthesia, oedema, acrocyanosis and punctate haemorrhagic lesions on her fingertips. The complaints began 2 days after the second cycle of a first‐line chemotherapy consisting of cisplatin or carboplatin, and gemcitabine due to advanced urothelial carcinoma. At the fingertips of both hands, haemorrhagic and partly ulcerative lesions were found; these were attributed to vascular toxicity of gemcitabine. Therapeutically sympathicolysis by bilateral blockade of the brachial plexus was performed, accompanied by intravenous administration of the prostacyclin analog iloprost, fractionated heparin subcutaneously and oral therapy with corticosteroids and aspirin. Digital amputation could be avoided. Acral ischemia is a rare but probably underreported adverse effect of gemcitabine therapy and a potential source of misdiagnosis.