Abstract
Gemcitabine is a nucleoside analogue used widely across haemato-oncology. Side effects are generally predictable, and typically consist of cytopenia, nausea, and infection. As the present case clearly demonstrates, gemcitabine is in rare cases associated with life-threatening large vessel vasculitis, which can involve the aorta. It is important to consider gemcitabine-induced vasculitis in non-specifically unwell patients with raised inflammatory markers and fever of unknown origin, with or without signs of vascular compromise. Early recognition, cessation of gemcitabine therapy, and high-dose steroids are critical for a good outcome. PET CT is valuable to diagnose large vessel vasculitis and monitor treatment response.
This is a preview of subscription content, log in via an institution to check access.
References
Lamberg SI, Bunn PA Jr. Cutaneous T-cell lymphomas: summary of the Mycosis Fungoides Cooperative Group-National Cancer Institute Workshop. Arch Dermatol. 1979;115:1103–10.
Banach MJ, Williams GA. Purtscher retinopathy and necrotizing vasculitis with gemcitabine therapy. Arch Ophthalmol. 2000;118:726–7.
Bendix N, Glodny B, Bernathova M, Bodner G. Sonography and CT of vasculitis during gemcitabine therapy. Am J Roentgenol. 2005;184:S14–5.
Birlik M, Akar S, Tuzel E, Onen F, Ozer E, Manisali M, et al. Gemcitabine-induced vasculitis in advanced transitional cell carcinoma of the bladder. J Cancer Res Clin Oncol. 2004;130:122–5.
Corella F, Dalmau J, Roé E, García-Navarro X, Alomar A. Cutaneous vasculitis associated with gemcitabine therapy. Clin Exp Dermatol. 2009;34:97–9.
Geisler JP, Schraith DF, Manahan KJ, Sorosky JI. Gemcitabine associated vasculitis leading to necrotizing enterocolitis and death in women undergoing primary treatment for epithelial ovarian/peritoneal cancer. Gynecol Oncol. 2004;92:705–7.
Schmorl P, Heer-Sonderhoff A, Vosshenrich R, Conrad S. Cerebral vasculitis associated with gemcitabine. Urologe A. 2010;49:268–70.
Thomas JG, Sethi S, Norby SM. Chronic thrombotic microangiopathy secondary to chemotherapy for urothelial carcinoma in a patient with a history of Wegener granulomatosis. Am J Kidney Dis. 2011;57:799–802.
Vénat-Bouvet L, Ly K, Szelag JC, Martin J, Labourey JL, Genet D, et al. Thrombotic microangiopathy and digital necrosis: two unrecognized toxicities of gemcitabine. Anticancer Drugs. 2003;14:829–32.
Voorburg AM, van Beek FT, Slee PH, Seldenrijk CA, Schramel FM. Vasculitis due to gemcitabine. Lung Cancer. 2002;36:203–5.
Ramsay LB, Stany MP, Edison JD, Bernstein SA, Schlegal KE, Hamilton CA. Gemcitabine-associated large vessel vasculitis presenting as fever of unknown origin. J Clin Rheumatol. 2010;16:181–2.
Conflict of interest
The authors declare that they have no conflict of interest relevant to the manuscript submitted to the International Journal of Hematology.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Eyre, T.A., Gooding, S., Patel, I. et al. Gemcitabine-induced large vessel vasculitis demonstrated by PET CT: a rare, important side effect. Int J Hematol 99, 798–800 (2014). https://doi.org/10.1007/s12185-014-1555-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12185-014-1555-5