A case of epirubicin-associated cardiotoxicity progressing to life-threatening heart failure and splenic thromboembolism.
We present the case of a 42-year-old Japanese woman who developed acute heart failure after chemotherapy with epirubicin for breast cancer. Echocardiography revealed a cardiac dysfunction with left ventricular thrombus. Serial serum troponin T tests were positive over a 5-week period, and an endomyocardial biopsy demonstrated ultrastructural lesions which were similar to those caused by cardiotoxicities due to doxorubicin. Although the patient developed splenic thromboembolism, her cardiac function recovered gradually, and she regained full range of her activities. This case report demonstrates that epirubicin-associated cardiotoxicity causes life-threatening heart failure and supportive care is important until the patient recovers from acute intoxication.
Department of Cardiology, Niigata Cancer Center Hospital, Japan. okuray@niigata-cc.jp
Yuji
Y
Okura
Takashi
T
Kawasaki
Chizuko
C
Kanbayashi
Nobuaki
N
Sato
D000328:Adult; D000970:Antineoplastic Agents / Q000633:toxicity*; D001943:Breast Neoplasms / Q000188:drug therapy; D015251:Epirubicin / Q000633:toxicity*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006333:Heart Failure / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D013154:Spleen / Q000098:blood supply*; D013923:Thromboembolism / Q000139:chemically induced* / Q000175:diagnosis; D020107:Troponin T / Q000097:blood
D000970:Antineoplastic Agents; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D020107:Troponin T; C036309:fibrin fragment D; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D015251:Epirubicin