title: Tyrosine kinase inhibitor induced isolated pericardial effusion.
abstract: Long-term therapy with tyrosine kinase inhibitors (TKI) has resulted in improved outcomes for patients suffering from Bcr-Abl fusion protein-harboring leukemias. As a result, a growing population of patients on TKI therapy present to their primary care providers. In this case, we report on the case of a 62-year-old male who presented with a symptomatic pericardial effusion. After pericardiocentesis, malignancy and infectious etiologies were excluded. The pericardial effusion was attributed to his TKI, with a transition of this medication to a different TKI. A repeat evaluation 1 month following the withdrawal of the offending agent showed no recurrence of his pericardial effusion on echocardiogram. In this report, we will highlight a rare but important side effect of TKI therapy before discussing its purported mechanisms and differing incidence rates. Early recognition of serosal inflammation related to long-term TKI therapy by primary care providers is important in preventing patient morbidity and mortality.
authors.affiliation: Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Md., USA.
authors.forename: Vineet
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Md., USA.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Christenson
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, Md., USA.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Showel
keywords: Leukemia; Pericardial effusion; Tyrosine kinase inhibitor
references.citation: Cancer. 2003 May 1;97(9):2229-35
references.pmid: 12712476
references.citation: Annu Rev Pharmacol Toxicol. 2013;53:161-85
references.pmid: 23043437
references.citation: Target Oncol. 2009 Apr;4(2):99-105
references.pmid: 19381453
references.citation: Cancer. 2012 Jun 15;118(12):3123-7
references.pmid: 22294282
references.citation: Dis Mon. 2012 Apr;58(4):168-76
references.pmid: 22449366
references.citation: Blood. 2007 Nov 15;110(10):3540-6
references.pmid: 17715389
references.citation: Eur Heart J. 2013 Apr;34(16):1186-97
references.pmid: 23125278
references.citation: Br J Haematol. 2008 May;141(5):745-7
references.pmid: 18331365
references.citation: N Engl J Med. 2014 Sep 11;371(11):1005-15
references.pmid: 25207766
references.citation: N Engl J Med. 2006 Dec 7;355(23):2408-17
references.pmid: 17151364
references.citation: J Clin Oncol. 2007 Sep 1;25(25):3908-14
references.pmid: 17761974