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Fatal Disseminated Tuberculosis during Treatment with Ruxolitinib Plus Prednisolone in a Patient with Primary Myelofibrosis: A Case Report and Review of the Literature

A 73-year-old man with primary myelofibrosis (PMF) was being treated with hydroxyurea, which was changed to ruxolitinib treatment because of worsening constitutional symptoms. Although ruxolitinib rapidly induced relief, he developed a high-grade fever. A comprehensive fever work-up found no apparen...

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Autores principales: Tsukamoto, Yasuhiro, Kiyasu, Junichi, Tsuda, Mariko, Ikeda, Motohiko, Shiratsuchi, Motoaki, Ogawa, Yoshihiro, Yufu, Yuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980814/
https://www.ncbi.nlm.nih.gov/pubmed/29279479
http://dx.doi.org/10.2169/internalmedicine.9165-17
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author Tsukamoto, Yasuhiro
Kiyasu, Junichi
Tsuda, Mariko
Ikeda, Motohiko
Shiratsuchi, Motoaki
Ogawa, Yoshihiro
Yufu, Yuji
author_facet Tsukamoto, Yasuhiro
Kiyasu, Junichi
Tsuda, Mariko
Ikeda, Motohiko
Shiratsuchi, Motoaki
Ogawa, Yoshihiro
Yufu, Yuji
author_sort Tsukamoto, Yasuhiro
collection PubMed
description A 73-year-old man with primary myelofibrosis (PMF) was being treated with hydroxyurea, which was changed to ruxolitinib treatment because of worsening constitutional symptoms. Although ruxolitinib rapidly induced relief, he developed a high-grade fever. A comprehensive fever work-up found no apparent cause of the fever, except for PMF. Therefore, we increased the dose of ruxolitinib and added prednisolone, which was gradually withdrawn with resolution of the fever. However, the patient subsequently developed disseminated tuberculosis and died eight months after initiation of ruxolitinib. Our case highlights the importance of assessing and monitoring the immune status of patients receiving ruxolitinib.
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spelling pubmed-59808142018-06-04 Fatal Disseminated Tuberculosis during Treatment with Ruxolitinib Plus Prednisolone in a Patient with Primary Myelofibrosis: A Case Report and Review of the Literature Tsukamoto, Yasuhiro Kiyasu, Junichi Tsuda, Mariko Ikeda, Motohiko Shiratsuchi, Motoaki Ogawa, Yoshihiro Yufu, Yuji Intern Med Case Report A 73-year-old man with primary myelofibrosis (PMF) was being treated with hydroxyurea, which was changed to ruxolitinib treatment because of worsening constitutional symptoms. Although ruxolitinib rapidly induced relief, he developed a high-grade fever. A comprehensive fever work-up found no apparent cause of the fever, except for PMF. Therefore, we increased the dose of ruxolitinib and added prednisolone, which was gradually withdrawn with resolution of the fever. However, the patient subsequently developed disseminated tuberculosis and died eight months after initiation of ruxolitinib. Our case highlights the importance of assessing and monitoring the immune status of patients receiving ruxolitinib. The Japanese Society of Internal Medicine 2017-12-27 2018-05-01 /pmc/articles/PMC5980814/ /pubmed/29279479 http://dx.doi.org/10.2169/internalmedicine.9165-17 Text en Copyright © 2018 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Tsukamoto, Yasuhiro
Kiyasu, Junichi
Tsuda, Mariko
Ikeda, Motohiko
Shiratsuchi, Motoaki
Ogawa, Yoshihiro
Yufu, Yuji
Fatal Disseminated Tuberculosis during Treatment with Ruxolitinib Plus Prednisolone in a Patient with Primary Myelofibrosis: A Case Report and Review of the Literature
title Fatal Disseminated Tuberculosis during Treatment with Ruxolitinib Plus Prednisolone in a Patient with Primary Myelofibrosis: A Case Report and Review of the Literature
title_full Fatal Disseminated Tuberculosis during Treatment with Ruxolitinib Plus Prednisolone in a Patient with Primary Myelofibrosis: A Case Report and Review of the Literature
title_fullStr Fatal Disseminated Tuberculosis during Treatment with Ruxolitinib Plus Prednisolone in a Patient with Primary Myelofibrosis: A Case Report and Review of the Literature
title_full_unstemmed Fatal Disseminated Tuberculosis during Treatment with Ruxolitinib Plus Prednisolone in a Patient with Primary Myelofibrosis: A Case Report and Review of the Literature
title_short Fatal Disseminated Tuberculosis during Treatment with Ruxolitinib Plus Prednisolone in a Patient with Primary Myelofibrosis: A Case Report and Review of the Literature
title_sort fatal disseminated tuberculosis during treatment with ruxolitinib plus prednisolone in a patient with primary myelofibrosis: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980814/
https://www.ncbi.nlm.nih.gov/pubmed/29279479
http://dx.doi.org/10.2169/internalmedicine.9165-17
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