title: Gemcitabine-induced large vessel vasculitis demonstrated by PET CT: a rare, important side effect.
abstract: Gemcitabine is a nucleoside analogue used widely across haemato-oncology. Side effects are generally predictable, and typically consist of cytopenia, nausea, and infection. As the present case clearly demonstrates, gemcitabine is in rare cases associated with life-threatening large vessel vasculitis, which can involve the aorta. It is important to consider gemcitabine-induced vasculitis in non-specifically unwell patients with raised inflammatory markers and fever of unknown origin, with or without signs of vascular compromise. Early recognition, cessation of gemcitabine therapy, and high-dose steroids are critical for a good outcome. PET CT is valuable to diagnose large vessel vasculitis and monitor treatment response.
authors.affiliation: Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Oxford, OX3 7EJ, UK, toby.eyre@ouh.nhs.uk.
authors.forename: Toby A
authors.initials: TA
authors.lastname: Eyre
authors.forename: Sarah
authors.initials: S
authors.lastname: Gooding
authors.forename: Ishita
authors.initials: I
authors.lastname: Patel
authors.forename: Niall
authors.initials: N
authors.lastname: Moore
authors.forename: Chris
authors.initials: C
authors.lastname: Hatton
authors.forename: Graham P
authors.initials: GP
authors.lastname: Collins
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D001013:Aorta, Thoracic / Q000473:pathology; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007083:Iliac Artery / Q000473:pathology; D008875:Middle Aged; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D014657:Vasculitis / Q000139:chemically induced* / Q000175:diagnosis*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D019788:Fluorodeoxyglucose F18; D000093542:Gemcitabine