Complex regional pain syndrome in a patient with neuroendocrine tumour under treatment with everolimus.

Everolimus is an immunosuppressant agent used in organ transplantation and, more recently, in cancer therapy. It has demonstrated beneficial effects in breast cancer, renal cancer, and neuroendocrine tumours. However, the treatment is not without side effects, some of which are still little known. We report the case of a 56 year-old man with a diagnosis of neuroendocrine tumour who developed a complex regional pain syndrome (CRPS) secondary to treatment with everolimus. CRPS has been linked to treatments with everolimus in renal and breast cancer patients as well as in renal transplant patients. To our knowledge, this is the first case of CRPS in a neuroendocrine tumour patient on everolimus treatment.

Frequency and outcomes of concomitant use of proton pump inhibitors and clopidogrel after hospital discharge.

OBJECTIVE: To assess the frequency of concomitant use of proton pump inhibitors (PPI) in patients treated with clopidogrel, and the potential impact of this use on cardiovascular events. METHOD: Three-month prospective observational study. All patients taking clopidogrel who were admitted to the study hospital were included in the study. They were split into categories based on whether they had taken the drug concomitantly with PPI upon admission, upon discharge or during follow-up, or if they had not taken the two drugs together at all. Any post-discharge readmissions for cardiovascular events in the three months following the original admission were also recorded. RESULTS: A total of 134 patients were included in the study. Only 26 patients (19,6%) did not take any PPI. Among 14 patients (10.5%) readmitted because of a cardiovascular event, 13 were taking clopidogrel concomitantly with a PPI (not statistically significant). Most of the readmitted patients presented other risk factors potentially related with cardiovascular events. CONCLUSION: This study underlines a high concomitant use of PPI with clopidogrel, with no evidence of an increasing risk of readmission due to cardiovascular event potentially related to a drug-drug interaction between these drugs. The study did not identify any readmission related to a gastro-intestinal complication.