title: Emphysematous cholecystitis in a patient with gastrointestinal stromal tumor treated with sunitinib.
abstract: A 50-year-old man had a metastatic gastrointestinal stromal tumor that was refractory to imatinib. He was prescribed a 6-week course of treatment with oral sunitinib 50 mg/day. During the fourth week of his first cycle of treatment with the drug, the patient developed acute-onset, right upper quadrant pain associated with nausea, vomiting, and fever; laboratory tests revealed leukocytosis and mild hyperbilirubinemia. He was diagnosed with acute emphysematous cholecystitis, which was treated with broad-spectrum antibiotics and percutaneous cholecystostomy. His symptoms resolved, and he successfully completed his course of therapy with sunitinib. Using the Naranjo adverse drug reaction probability scale, a score of 5 was derived, which indicates that the likelihood was probable that this adverse event was caused by sunitinib.
authors.affiliation: Johns Hopkins Singapore International Medical Center, Singapore. glopes.md@gmail.com
authors.forename: Gilberto
authors.initials: G
authors.lastname: de Lima Lopes
authors.forename: Caio Max
authors.initials: CM
authors.lastname: Rocha Lima
mesh_terms: D000208:Acute Disease; D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002767:Cholecystostomy; D041882:Emphysematous Cholecystitis / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy; D006801:Humans; D006932:Hyperbilirubinemia / Q000139:chemically induced; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use; D007964:Leukocytosis / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011336:Probability; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use; D000077210:Sunitinib; D014057:Tomography, X-Ray Computed
chemical_list: D020533:Angiogenesis Inhibitors; D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib