PDF(Pubmed)
Abstract：
A 69-year-old woman presented to our department with the chief complaint of diarrhea. She had undergone left nephrectomy for renal cancer 14 years earlier. Three years earlier, metastasis was detected in the left retroperitoneal cavity, and pazopanib administration was initiated. In the 29th month after the start of chemotherapy, the patient developed diarrhea, and on the 31st month, computed tomography showed thickening of the intestinal wall. Colonoscopy revealed white villi, intramucosal hemorrhage in the terminal ileum, and rough inflammatory mucosa with inflammatory polyps extending from the transverse to the sigmoid colon. Suspecting pazopanib-induced enteritis, we discontinued the medication, and the diarrhea resolved within 3 days. On the 21st day after discontinuation, colonoscopy revealed that the inflammatory polyps had shrunk, and the inflammatory findings had improved. Biopsy of the white villi of the ileum revealed histiocytes. The patient resumed treatment with pazopanib at 400 mg/day and developed soft stool on the 7th day after resumption. Compared with other tyrosine-kinase inhibitor-induced enteritis cases, this case showed less bleeding and more extensive inflammatory findings. There are similarities as well as differences from cases of previously reported pazopanib-induced enteritis. The mechanisms and characteristics of this disease require further investigation.
摘要：
一名69岁的妇女向我们部门提出腹泻的主要投诉。14年前，她因肾癌接受了左肾切除术。三年前,在左腹膜后腔中检测到转移，开始使用帕唑帕尼。化疗开始后的第29个月,病人出现腹泻,在第31个月,计算机断层扫描显示肠壁增厚。结肠镜检查显示白色绒毛,回肠末端粘膜内出血，和粗糙的炎性粘膜，炎性息肉从横结肠延伸到乙状结肠。怀疑帕唑帕尼引起的肠炎，我们停药了,腹泻在3天内缓解。停药后的第21天,结肠镜检查显示炎性息肉缩小了,炎症的发现有所改善。回肠白色绒毛的活检显示组织细胞。患者恢复400mg/天的帕唑帕尼治疗，恢复后第7天出现软便。与其他酪氨酸激酶抑制剂引起的肠炎病例相比，该病例显示出血较少,炎症表现更广泛.与先前报道的帕唑帕尼诱导的肠炎病例既有相似之处，也有不同之处。这种疾病的机制和特征需要进一步研究。
