Digital necrosis related to carboplatin and gemcitabine therapy in systemic sclerosis.
We present a woman with scleroderma who developed multiple ischemic digits after chemotherapy for lung cancer. The ischemia started during treatment with carboplatin and gemcitabine and required amputation of the affected digits. A review of the literature shows that thrombotic episodes coinciding with chemotherapy are not uncommon, though venous thrombosis occurs more frequently than arterial. Scleroderma patients are at particular risk for digital infarction because of their underlying vascular disease and associated Raynaud's phenomenon. This case illustrates the risk of severe digital ischemia and digital loss in patients with scleroderma during chemotherapy with carboplatin and gemcitabine.
Clowse
Megan E B
ME
Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Wigley
Fredrick M
FM
D000970:Antineoplastic Agents / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects*; D003841:Deoxycytidine / Q000009:adverse effects* / Q000031:analogs & derivatives*; D004359:Drug Therapy, Combination; D005260:Female; D005385:Fingers / Q000473:pathology; D005734:Gangrene / Q000139:chemically induced; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007238:Infarction / Q000139:chemically induced; D008875:Middle Aged; D009336:Necrosis; D012595:Scleroderma, Systemic / Q000188:drug therapy* / Q000473:pathology; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D003841:Deoxycytidine; D016190:Carboplatin; D000093542:Gemcitabine