Ogilvie's syndrome in acute myeloid leukemia: pharmacological approach with neostigmine.
Acute colonic pseudo-obstruction, the so-called Ogilvie's syndrome, is a rare and life-threatening digestive complication usually observed in critically ill patients. It is characterized by signs of large-bowel obstruction, without a mechanical cause, and has been reported in various settings, including acute leukemias as a complication of neutropenic enterocolitis after intensive chemotherapy. We describe the case of a young woman who, during the neutropenic phase following autologous bone marrow transplantation for relapsed acute myeloid leukemia, developed neutropenic enterocolitis complicated by an acute pseudo-obstruction of descendent colon and sigma. This process was associated with sepsis and resolved with conservative therapy of the underlying condition, using granulocyte colony-stimulating factor and intravenous neostigmine. We discuss the management of this rare syndrome.
Breccia
M
M
Dipartimento di Biotecnologie Cellulari ed Ematologia, University La Sapienza, Rome, Italy. mbreccia@hotmail.com
Girmenia
C
C
Mecarocci
S
S
Cartoni
C
C
Carmosino
I
I
Tafuri
A
A
Alimena
G
G
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003112:Colonic Pseudo-Obstruction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D004760:Enterocolitis / Q000150:complications; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000628:therapy; D009388:Neostigmine / Q000627:therapeutic use*; D009503:Neutropenia / Q000150:complications; D012008:Recurrence; D014463:Ultrasonography
D002800:Cholinesterase Inhibitors; D009388:Neostigmine