Death due to exfoliative dermatitis, diarrhea, and myelosuppression caused by pemetrexed
10.3760/cma.j.cn114015-20190314-00259
- VernacularTitle:培美曲塞引起剥脱性皮炎、腹泻和骨髓抑制致死亡
- Author:
Xiaohong GUO
1
;
Dan MEI
1
;
Yanyan XU
1
;
Haijuan GU
1
;
Jinling DENG
1
Author Information
1. 南通大学附属肿瘤医院药剂科 226361
- Publication Type:Journal Article
- Keywords:
Pemetrexed;
Antineoplastic agents;
Dermatitis, exfoliative;
Diarrhea;
Pancytopenia;
Death
- From:
Adverse Drug Reactions Journal
2020;22(7):418-419
- CountryChina
- Language:Chinese
-
Abstract:
A 74-year-old male patient was treated with pemetrexed on the basis of erlotinib for lung adenocarcinoma. For the first time, pemetrexed 800 mg dissolved in 0.9% sodium chloride 100 ml was given by intravenous injection. On the 3rd day after the treatment, the patient developed generalized skin rash, and then ulceration of oral mucosa and skin ulceration of perianal and scrotal area gradually appeared. The patient was diagnosed with exfoliative dermatitis. On the 6th day after the treatment, the patient developed diarrhea, which was gradually aggravated with the increased frequency from 3 to 4 times to 10 to 12 times daily. On the 9th day, after the treatment the patient developed myelosuppression (grade IV), with white blood cell count (WBC) 0.6×10 9/L, neutrophils count 0.1×10 9/L, red blood cell count (RBC) 2.04×10 12/L, hemoglobin (Hb) 65 g/L, and platelet count (PLT) 77×10 9/L. Despite the active treatments with anti-allergy, antidiarrheal, and blood cell regeneration stimulating drugs, the patient′s myelosuppression was aggravated. On the 15th day after the treatment, laboratory tests showed WBC 0.1×10 9/L, neutrophil count 0, RBC 2.53×10 12/L, Hb 80 g/L, and PLT 1×10 9/L. The patient′s treatment was given up at the request of his family members and the patient died on the 18th day after the treatment.
