title: [Early onset of paralytic ileus caused by simultaneous administration of bortezomib and azole antifungals in multiple myeloma patients].
abstract: We herein report two patients (70- and 45-year-old men) with refractory multiple myeloma who developed paralytic ileus shortly after starting bortezomib therapy. Bortezomib (1.3 mg/m(2)) was given on days 1, 4, 8, and 11 with daily oral solution itraconazole or voriconazole. Twelve and 15 days after beginning the therapy, each patient developed paralytic ileus. Interestingly, no other signs of peripheral neuropathy such as fingertip numbness were observed at the onset of ileus. Sporadic cases of paralytic ileus after bortezomib therapy have been reported, most of which developed ileus after several courses of bortezomib therapy. Our cases developed paralytic ileus shortly after initiating bortezomib, strongly suggesting that autonomic neuropathy due to bortezomib was induced by the concomitant use of itraconazole or voriconazole.
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Koda
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shimizu
authors.forename: Jun
authors.initials: J
authors.lastname: Kato
authors.forename: Akiko
authors.initials: A
authors.lastname: Yamane
authors.forename: Ken
authors.initials: K
authors.lastname: Sadahira
authors.forename: Yuiko
authors.initials: Y
authors.lastname: Tsukada
authors.forename: Kenji
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Norisato
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hattori
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okamoto
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects*; D000069286:Bortezomib; D004347:Drug Interactions; D004359:Drug Therapy, Combination / Q000009:adverse effects; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000139:chemically induced*; D017964:Itraconazole / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D009181:Mycoses / Q000517:prevention & control; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects*; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects*; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D000069286:Bortezomib; D065819:Voriconazole