Scurvy in a patient on vemurafenib
نویسندگان
چکیده
CASE REPORT A66-year-oldwhitemanwith stage IIICmelanoma diagnosed in 2009 was treated with high-dose interferon alfa-2b for 1 year. He subsequently had subcutaneous and brainmetastases and underwent 2 cycles of high-dose interleukin-2 and whole-brain irradiation. Given disease progression, vemurafenib was initiated at 960 mg twice daily after testing confirmed the BRAF V600E mutation. After 4 months of treatment, systemic symptoms of severe fatigue, anorexia/dysgeusia, and arthralgias developed as did cutaneous manifestations including xerosis, a keratosis pilariselike eruption on the trunk and extremities, and corkscrew hairs on the upper back, which were not present before vemurafenib therapy (Figs 1 and 2). The clinical symptomswere consistent with several reported side effects of vemurafenib; however, the additional finding of corkscrew hairs prompted the consideration of vitamin C deficiency resulting in scurvy. Other findings of scurvy such as petechiae, gingivitis, and poor wound healing were not present. Further investigation found low plasma vitamin C levels on 2 independent determinations 1 week apart (0.0 mg/dL and 0.1 mg/dL [0.4e2.0 mg/ dL]). Upon questioning, the patient reported decreased appetite with specific reduced intake of
منابع مشابه
Successful Rechallenge with Vemurafenib and Corticosteroids in a Patient with Vemurafenib Induced Liver Dysfunction, Previously Treated with Ipilimumab
متن کامل
Scurvy in the Postoperative Oropharyngeal Cancer Patient
Scurvy is now an almost forgotten disease, but it hasn’t yet disappeared entirely. Here, we report the case of a patient with scurvy who presented with multiple hemorrhages about 5 years after undergoing pharyngeal surgery and radiochemotherapy for oropharyngeal cancer. This 60-year-old man was admitted to our hospital because of sudden onset of dyspnea and purpura. A physical examination and c...
متن کاملVemurafenib-related sterile scrotal abscess in a patient with BRAFV600K-mutant advanced melanoma mimicking distant metastasis.
BACKGROUND Vemurafenib is a selective BRAF-inhibitor that has been approved for the use in patients with advanced BRAF-mutant melanoma. Major adverse events include skin rash, photosensitivity, pruritus, cutaneous squamous-cell carcinoma or keratoacanthoma. OBSERVATION We present the case of a patient experiencing extensive sterile abscess of the scrotum after nine months of treatment with ve...
متن کاملSuccessful re-treatment of a relapsed V600E mutated HCL patient with low-dose vemurafenib
Hairy cell leukemia (HCL) is a chronic B-cell lymphoproliferative disorder that accounts for 2% of all leukemia. Recent identification of the recurrent V600E BRAF mutation in a majority of HCL patients has led some teams to evaluate the clinical potential of vemurafenib, a BRAF V600 specific inhibitor in a limited number of refractory HCL patients. Recently, we published the case of an HCL pati...
متن کاملModern scurvy Rian
Scurvy is a disease that played an important role in ancient history and used to be a notorious cause of death in sailors. Nowadays, scurvy is not a commondiagnosis in the civilizedworld, but this case report indicates that this old-fashioneddisease is not extinct at all and still exists but in a different patient category.
متن کامل