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Rare upper gastrointestinal hemorrhage of cetuximab: A case report

RATIONALE: cetuximab, an epidermal growth factor receptor inhibitor, is a targeted therapeutic regimen of colorectal cancers. Several common adverse effects have been found, such as cutaneous or gastrointestinal toxicity. However, according to the articles had been published, upper gastrointestinal...

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Autores principales: Duan, Shi-Jie, Gao, Zi-Ming, Wang, Peng-Liang, Gong, Bao-Cheng, Huang, Han-Wei, Luo, Lei, Wang, Xin, Xing, Ya-Nan, Xu, Hui-Mian, Liu, Fu-Nan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758247/
https://www.ncbi.nlm.nih.gov/pubmed/29390545
http://dx.doi.org/10.1097/MD.0000000000009391
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author Duan, Shi-Jie
Gao, Zi-Ming
Wang, Peng-Liang
Gong, Bao-Cheng
Huang, Han-Wei
Luo, Lei
Wang, Xin
Xing, Ya-Nan
Xu, Hui-Mian
Liu, Fu-Nan
author_facet Duan, Shi-Jie
Gao, Zi-Ming
Wang, Peng-Liang
Gong, Bao-Cheng
Huang, Han-Wei
Luo, Lei
Wang, Xin
Xing, Ya-Nan
Xu, Hui-Mian
Liu, Fu-Nan
author_sort Duan, Shi-Jie
collection PubMed
description RATIONALE: cetuximab, an epidermal growth factor receptor inhibitor, is a targeted therapeutic regimen of colorectal cancers. Several common adverse effects have been found, such as cutaneous or gastrointestinal toxicity. However, according to the articles had been published, upper gastrointestinal bleeding (UGIB) is considered to be rare and its mechanism remains unclear. PATIENT CONCERNS: In this report, we presented a 42-year-old male patient with advanced recto-sigmoid cancer. After palliative operation, the patient suffered from complete upper gastrointestinal (GI) obstruction, which was induced by extensive abdominal metastasis of the tumor. Considering his poor condition, we chose the targeted drug, cetuximab, as his further treatment. But after the application of cetuximab, the UGIB immediately happened twice in this patient. DIAGNOSIS: UGIB, as a rare complication of cetuximab, occured to the patient. INTERVENTIONS: We stopped the bleeding with thrombin, hemocoagulase and somatostatin and suspended the subsequent treatment plan of cetuximab. At the same time, anti-shock treatment was given immediately. OUTCOMES: He was died of respiratory and circulatory failure caused by UGIB and advanced tumor eventually. LESSONS: UGIB should be considered as a rare but severe complication of cetuximab. When cetuximab is applied for patients with advanced colon tumors, more cautions should be required if the patients are accompanied by upper gastrointestinal obstruction. In addition, for those patients who suffered from UGIB recently, cetuximab should be prohibited if the Rockall score ranged > 5 points.
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spelling pubmed-57582472018-01-29 Rare upper gastrointestinal hemorrhage of cetuximab: A case report Duan, Shi-Jie Gao, Zi-Ming Wang, Peng-Liang Gong, Bao-Cheng Huang, Han-Wei Luo, Lei Wang, Xin Xing, Ya-Nan Xu, Hui-Mian Liu, Fu-Nan Medicine (Baltimore) 5700 RATIONALE: cetuximab, an epidermal growth factor receptor inhibitor, is a targeted therapeutic regimen of colorectal cancers. Several common adverse effects have been found, such as cutaneous or gastrointestinal toxicity. However, according to the articles had been published, upper gastrointestinal bleeding (UGIB) is considered to be rare and its mechanism remains unclear. PATIENT CONCERNS: In this report, we presented a 42-year-old male patient with advanced recto-sigmoid cancer. After palliative operation, the patient suffered from complete upper gastrointestinal (GI) obstruction, which was induced by extensive abdominal metastasis of the tumor. Considering his poor condition, we chose the targeted drug, cetuximab, as his further treatment. But after the application of cetuximab, the UGIB immediately happened twice in this patient. DIAGNOSIS: UGIB, as a rare complication of cetuximab, occured to the patient. INTERVENTIONS: We stopped the bleeding with thrombin, hemocoagulase and somatostatin and suspended the subsequent treatment plan of cetuximab. At the same time, anti-shock treatment was given immediately. OUTCOMES: He was died of respiratory and circulatory failure caused by UGIB and advanced tumor eventually. LESSONS: UGIB should be considered as a rare but severe complication of cetuximab. When cetuximab is applied for patients with advanced colon tumors, more cautions should be required if the patients are accompanied by upper gastrointestinal obstruction. In addition, for those patients who suffered from UGIB recently, cetuximab should be prohibited if the Rockall score ranged > 5 points. Wolters Kluwer Health 2017-12-22 /pmc/articles/PMC5758247/ /pubmed/29390545 http://dx.doi.org/10.1097/MD.0000000000009391 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5700
Duan, Shi-Jie
Gao, Zi-Ming
Wang, Peng-Liang
Gong, Bao-Cheng
Huang, Han-Wei
Luo, Lei
Wang, Xin
Xing, Ya-Nan
Xu, Hui-Mian
Liu, Fu-Nan
Rare upper gastrointestinal hemorrhage of cetuximab: A case report
title Rare upper gastrointestinal hemorrhage of cetuximab: A case report
title_full Rare upper gastrointestinal hemorrhage of cetuximab: A case report
title_fullStr Rare upper gastrointestinal hemorrhage of cetuximab: A case report
title_full_unstemmed Rare upper gastrointestinal hemorrhage of cetuximab: A case report
title_short Rare upper gastrointestinal hemorrhage of cetuximab: A case report
title_sort rare upper gastrointestinal hemorrhage of cetuximab: a case report
topic 5700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758247/
https://www.ncbi.nlm.nih.gov/pubmed/29390545
http://dx.doi.org/10.1097/MD.0000000000009391
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