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Imatinib-induced fatal acute liver failure

World Journal of Gastroenterology 2007年第48期13卷 6608-6611页

作者： Ezequiel Ridruejo roberto cacchione Alejandra G Villamil Sebastián Marciano Adrián C Gadano Oscar G Mandó Hepatology Section Hematology Section Department of Medicine Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" CEMIC Buenos Aires Argentina Liver Unit Hospital Italiano de Buenos Aires Buenos Aires Argentina

Imatinib mesylate is a drug that has been approved for treatment of chronic myeloid leukemia (CML) in blast crisis, accelerated or chronic phase, and also for advanced gastrointestinal stromal tumors. Severe hepatic toxicity and three deaths from hepatic failure have been reported. We report the case of a 51-year-old woman who was admitted to our institution with severe acute hepatitis. She was diagnosed with CML and began treatment with imatinib mesylate at a dose of 400 mg/d. Five months after beginning treatment, she developed severe hepatitis associated with coagulopathy, and was admitted to our institution. She had been consuming acetaminophen 500-1000 mg/d after the onset of symptoms. She had a progressive increase in bilirubin level and a marked decrease of clotting factor Ⅴ. Five days after admission, grade Ⅱ encephalopathy developed and she was referred for liver transplantation. Her clinical condition progressively deteriorated, and 48 h after being referred for transplantation she suffered a cardiac arrest and died. This report adds concern about the possibility of imatinib-mesylate-induced hepatotoxicity and liver failure, particularly in the case of concomitant use with acetaminophen. Liver function tests should be carefully monitored during treatment and, with the appearance of any elevation of liver function tests, treatment should be discontinued.

关键词： Imatinib mesylate Hepatotoxicity Acute liver failure Liver transplantation

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Pediatric spinal glioblastoma of the conus medullaris:a case report of long survival

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Chinese Journal of Cancer 2016年第6期35卷 69-72页

作者： Antonella cacchione Angela Mastronuzzi Maria Giuseppina Cefalo Giovanna Stefania Colafati Francesca Diomedi-Camassei Michele Rizzi Alessandro De Benedictis Andrea Carai Department of Pediatric Hematology-OncologyBambino GesùChildren’s Hospital IRCCSPlazza Sant'Onofrio 400615 RomeItaly Neuroradiology Unit Bambino GesùChildren’s HospitalPlazza Sant'Onofrio 400615 RomeItaly Division of Pathology Bambino GesùChildren’s HospitalPlazza Sant'Onofrino 400615 RomeItaly Department of Neurosurgery Fondazione Istituto Neurologico"Carlo Besta"IRCCSMilanItaly Neurosurgery Unit Department of Neuroscience and NeurorehabilitationBambino GesùChildren’s HospitalPlazza Sant'Onofrio 400615 RomeItaly

High?grade gliomas of the spinal cord represent a rare entity in *** biology,behavior,and controversial treatment options have been discussed in a few pediatric *** tumors are associated with severe disability and poor *** report a case of a 4?year?old child diagnosed with an isolated glioblastoma multiforme of the conus *** patient underwent subtotal surgical excision,followed by adjuvant radiotherapy and oral chem?*** is alive with mild neurologic deficits at 52 months after *** describe the peculiar characteris?tics of this rare condition in pediatric *** also provide an overview of current multidisciplinary therapeutic approaches and prognostic factors for this disease.

关键词： Spinal cord cancer Glioblastoma multiforme Children Multidisciplinary treatment Prognosis

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常规食管双极pH监测中近端传感器的数据常不够准确

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世界核心医学期刊文摘（胃肠病学分册） 2005年第3期1卷 14-15页

作者： McCollough M. Jabbar A. cacchione R. 樊菁

Dual sensor esophageal pH monitoring is routinely used to diagnose GERD. However, the proximal sensor may not be in proximal esophagus in patients with shortened esophagi. Our objective was to determine how often the proximal sensor was misplaced and to determine the effect on pH monitoring. Superior margins of the upper and lower esophageal sphincters (UES and LES) were determined prospectively in consecutive patients. Dual sensors were placed 20 and 5 cm above the LES with a fixed 15 cm spacing pH catheter. Patients were classified into subgroups based on the actual location of the proximal sensor. In 661 patients, the proximal pH sensor was in the hypopharynx in 9%of patients, within the UES in 36%, and in the proximal esophagus in 55%. Spearman’s correlation for acid exposure was very good between the dual sensors when the proximal sensor was in the proximal esophagus (R=0.76)but was poor when the proximal sensor was misplaced in the hypopharynx (R=0.28). The proximal sensor was misplaced in 45%of patients undergoing dual sensor esophageal pH monitoring. It is important to locate the UES by manometry before interpreting the proximal esophageal pH data.

关键词： pH监测近端胃食管反流上缘亚群测压法

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