ABSTRACT
INTRODUCTION: Pembrolizumab is a monoclonal antibody approved for adult patients with advanced non-small-cell lung cancer (NSCLC). Although immune related adverse events are considered to be well tolerated, complications may occur and discontinuation of the treatment could be required. CASE REPORT: A 62-year old patient diagnosed with advanced non-small cell lung cancer experienced a decline in the renal function after seven cycles with pembrolizumab.Management & outcome: After ruling out other common causes of interstitial nephritis, pembrolizumab was attributed as a cause of interstitial nephritis. At first, toxicity was managed with corticosteroids and closely monitoring the patient, but finally pembrolizumab had to be discontinued due to the kidney function did not recover. DISCUSSION: Renal and urinary disorders were reported in <3% of patients treated with pembrolizumab, being interstitial nephritis the most reported toxicity. The kidney damage can be a complication to consider in patients receiving pembrolizumab. Early identification of an increase in serum creatinine levels may help with prevention by establishing an effective treatment, although it may not mean a total recovery of kidney function.
Subject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Nephritis, Interstitial/chemically induced , Nephritis, Interstitial/diagnostic imaging , Antibodies, Monoclonal/adverse effects , Antineoplastic Agents, Immunological/adverse effects , Carcinoma, Non-Small-Cell Lung/blood , Carcinoma, Non-Small-Cell Lung/drug therapy , Humans , Lung Neoplasms/blood , Lung Neoplasms/drug therapy , Male , Middle Aged , Nephritis, Interstitial/bloodABSTRACT
Las reacciones alérgicas y cutáneas para fluoroquinolonas las presentan entre el 0,4% y el 2,2% de los pacientes. Se presenta un protocolo de desensibilización por vía intravenosa que se desarrolla en 4 horas con dosis de 0,05 mg hasta una dosis acumulada de 750 mg
Allergic and cutaneous reactions to fluoroquinolones are shown among 0.4% and 2.2% of the patients. A protocol of intravenous desensitization is presented, which develops in 4 hours with a dose of 0.05 mg to a cumulative dose of 750 mg
Subject(s)
Humans , Male , Aged , Desensitization, Immunologic/methods , Levofloxacin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Fluoroquinolones/administration & dosage , Postoperative Complications/drug therapy , Ankle Fractures/surgery , Levofloxacin/adverse effects , Anti-Bacterial Agents/adverse effects , Fluoroquinolones/adverse effects , Clinical ProtocolsABSTRACT
Aunque la mortalidad por intoxicación aguda es muy reducida, sus repercusiones tanto sanitarias como sociales son evidentes y requieren un profundo análisis. El objetivo del presente estudio es conocer el número y tipo de intoxicaciones agudas registradas en el Hospital Povisa de Vigo en 2013 y analizar sus características. Se realizó un estudio descriptivo de incidencia revisando las historias clínicas de los 386 pacientes atendidos en el Servicio de Urgencias por intoxicación aguda desde el 1 de enero hasta el 31 de diciembre 2013. Los tóxicos más frecuentes fueron las drogas de abuso (61,9%), principalmente alcohol, seguidas por los medicamentos (40,4%) (benzodiacepinas mayoritariamente). La máxima incidencia fue en viernes y sábados (34,2%). El tiempo transcurrido hasta recibir el alta médica fue inferior a 12 horas en el 81,6% de los casos. La intencionalidad suicida fue la más frecuente (33,4%). Entre las manifestaciones clínicas predominaron las neurológicas. La muerte se produjo únicamente en 1 paciente (0,26%).Los datos obtenidos coinciden con la bibliografía publicada, las intoxicaciones por drogas de abuso predominaron entre los hombres y las medicamentosas entre las mujeres. La intencionalidad suicida fue la más frecuente, con diferencias estadísticamente significativas entre sexos, en las mujeres predominó efectivamente la intencionalidad suicida, y en los hombres, la dependencia a sustancias tóxicas, principalmente alcohol (AU)
Epidemiological study of acute intoxication cases treated in Povisa hospital (Vigo, Spain) during one year. The objective of this study was to know the number and the type of acute intoxications registered in the Vigos hospital Povisa, its intention, chronology, toxics involved, precedents the patients presented at the admission, its clinical practice, evolution and treatment administered. Furthermore, the data obtained was compared with similar studies carried out in other health areas. For this purpose, a descriptive study of incidence was carried out by reviewing the clinical history of 386 patients with acute intoxication treated at a hospital emergency department. The most frequent toxics were drugs of abuse (61.9%), mainly alcohol, followed by medication (40.4%) (mostly benzodiazepines). The peak incidence was on Fridays and Saturdays (34.2%). The time passed until patients were discharged from the hospital was less than 12 hours in 81.6% of the cases. Suicidal purpose was the most frequent (33.4%). Neurological symptoms predominate among the clinical manifestations. Death was registered only in one patient (0.26%). The intoxications by drugs of abuse predominated among men and the ones by medication abuse among women. The most frequent purpose was the suicidal attempt, with significant differences by gender (suicidal intention was the main purpose in women, and addiction to toxic substances in men, mainly alcohol). There were psychiatric precedents or previous intoxications in more than half of the cases researched. After being attended in the Emergency Department, more than half of the patients were discharged from the hospital (AU)
