Neutropenic enterocolitis in breast cancer patient after taxane-containing chemotherapy.
Neutropenic enterocolitis or typhlitis (from the Greek typhlon, meaning caecum) is defined as a necrotizing colitis with inflammation of the cecum and surrounding tissues. Although this condition occurs primarily in severely myelosuppressed and immunosuppressed patients with leukemia, it may also occur in those with other advanced malignancies receiving myelosuppressive chemotherapy. It has been described most recently in patients with solid tumors who receive taxane-based therapy. A 60-year old woman with medullary breast cancer stage IIIB underwent neoadjuvant chemotherapy with TAC (doxetaxele 100 mg/m2, doxorubicin 50 mg/m2 and cyclophosphamide 600 mg/m2). Sixth day after TAC chemotherapy, she had abdominal pain and vomiting. Abdomen CT scan showed diffuse circumferential thickening of ileum wall typical for ileitis, narrowing of the lumen, disturbance of peristaltic. This abdomen CT scan was thought as abnormality pictures of neutropenic enterocolitis. Neutropenic enterocolitis should be considered in patients with abdominal symptoms especially during the granulocyte nadir following chemotherapy. Increased awareness of this rapidly progressive and potentially fatal disease leads to accurate diagnosis and the prompt treatment that can decrease morbidity and mortality.
Oehadian
Amaylia
A
Division of Hematology and Medical Oncology, Department of Internal Medicine, Padjajaran University, Hasan Sadikin Hospital, Jl. Pasteur no. 38, Bandung. amaylia_oehadian@yahoo.com
Fadjari
Trinugroho Heri
TH
D015746:Abdominal Pain / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D044504:Enterocolitis, Neutropenic / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D014057:Tomography, X-Ray Computed
D043823:Taxoids; D004317:Doxorubicin; D003520:Cyclophosphamide