Neutropenic enterocolitis in adults: systematic analysis of evidence quality

Gorschlüter, Marcus; Mey, Ulrich; Strehl, John; Ziske, Carsten; Schepke, Michael; Schmidt‐Wolf, Ingo G.H.; Sauerbruch, Tilman; Glasmacher, Axel

doi:10.1111/j.1600-0609.2005.00442.x

Cited by 233 publications

(216 citation statements)

References 139 publications

(152 reference statements)

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“…Neutropenic enterocolitis (in the early 1970's referred to as typhilits) is the most important clinical entity among abdominal infections in neutropenic adults [61]. This acute inflammatory disease may involve coecum, colon, and the terminal part of ileum.…”

Section: Gastrointestinal Infectionsmentioning

confidence: 99%

Risk of Infections in Adult Patients with Haematological Malignancies

Nørgaard¹

2012

TOIDJ

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Abstract:Patients with haematological malignancies are at increased risk of infections not only because of the malignancy itself but also because of neutropenia induced by intensive chemotherapeutic treatment, and the cytotoxic effect on the cells that line the alimentary tract. In haematological malignancy patients with a compromised inflammatory response, the classic signs and symptoms of infection may be masked. The results of blood cultures therefore play an important diagnostic role. Bacteraemia is a relatively common serious complication occurring in around 15% of patients with haematological malignancies within the first years after diagnosis but the risk varies between different types of haematological malignancies. Other risk factors for bacteraemia are presence of mucositis, neutropenia, and use of central venous catheters. Invasive fungal diseases are also serious infectious complications in this population. Viral infections are particularty often in patients that have received a bone marrow transplant. Future work in this field could focus on potential modifiable risk factors and on how time since haematological diagnosis may influence risk of infection.

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Section: Gastrointestinal Infectionsmentioning

confidence: 99%

Risk of Infections in Adult Patients with Haematological Malignancies

Nørgaard¹

2012

TOIDJ

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“…NEC in cytopenic patients ranges from 2.6% [6] to 33% [7] with a pooled incidence rate of 5.3% related to 21 studies [8]. Despite aggressive management, mortality rates are high 21e48% [9].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound findings guided a successful hemicolectomy in a leukemic patient with neutropenic enterocolitis

Benedetti

Lippolis

Caracciolo

et al. 2008

Journal of Ultrasound

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Introduction: Neutropenic enterocolitis (NEC) can be a life-threatening complication of chemotherapy in leukemic patients. Early diagnosis and treatment is therefore crucial. Methods: A 38-year-old woman with acute lymphoblastic leukemia and chemotherapy-induced neutropenia suddenly developed symptoms suspicious of NEC. Transabdominal ultrasound showed features consistent with NEC, later confirmed by computed tomography (CT) scan. Results: The patient was scanned using portable ultrasound (US) equipment (Esaote My Lab 25). US findings showed involvement of the cecum, appendix, ascending colon and proximal middle transverse colon, with features resembling gas containing fissures within the colon wall itself. The risk of colon rupture was confirmed by CT scan. The patient underwent successful hemicolectomy after intravenous treatment with broad spectrum antibiotics, granulocytecolony stimulating factor (G-CSF), platelets and fresh frozen plasma transfusion. Discussion: A prompt bedside US examination upon development of symptoms allowed an early diagnosis of NEC and identified features consistent with imminent colon wall rupture, shifting the management of this life-threatening complication from medical to surgical. Multidisciplinary intervention was crucial for a successful hemicolectomy in a severely affected neutropenic patient.Sommario Introduzione: La tiflite (Neutropenic enterocolitis, NEC) può essere una complicanza fatale in pazienti affetti da leucemia e sottoposti a chemioterapia. Una precoce diagnosi e terapia sono essenziali. Metodi: Una donna di 38 anni affetta da leucemia linfoblastica acuta durante la neutropenia indotta dalla chemioterapia improvvisamente ha sviluppato segni e sintomi compatibili con NEC. Una ecografia addominale ha mostrato segni di NEC confermati successivamente con la TC. Risultati: È stato utilizzato un ecografo portatile (Esaote My Lab 25). Segni ecografici di coinvolgimento intestinale sono stati trovati a carico del cieco, appendice, colon ascendente e della parte prossimale del colon trasverso, con aspetti compatibili con presenza di gas nella parete stessa. Il rischio di perforazione del colon è stato confermato con l'esame TC. La paziente è stata sottoposta con successo a una emicolectomia dopo aver ricevuto antibiotici per endovena, G-CSF, e trasfusione di granulociti, piastrine e plasma fresco congelato. Discussione: Una ecografia eseguita precocemente al letto del paziente appena sono comparsi i sintomi ha permesso non solo di identificare segni compatibili con NEC, ma di identificare segni di possibile imminente rottura della parete, cambiando il trattamento da medico a chirurgico. Un intervento multidisciplinare è stato essenziale permettendo alla paziente di essere sottoposta con successo a una emicolectomia durante neutropenia. ª

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“…However, two cases of severe neutropenic enterocolitis (NEC) have been reported after the treatment with pemetrexed during treatment of NSCLC [4,5]. The incidence of NEC is unknown, but its occurrence is mainly attributed to neutropenia-inducing chemotherapies for acute leukaemias with a reported incidence of around 5% [6].…”

Section: Introductionmentioning

confidence: 99%

Pemetrexed-induced neutropenic enteritis and severe cutaneous hyperpigmentation in a patient with malignant pleural mesothelioma

et al. 2013

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Neutropenic enteritis (NE) or enterocolitis (NEC) is a rare, but potentially life-threatening side effect of neutropenia-inducing chemotherapy agents. Generally, its occurrence is attributed to leukemiaassociated chemotherapies. Two cases of NE have been reported after the appliance of pemetrexed for treatment of non-small cell lung cancers. To our knowledge, NE has never been reported due to treatment with pemetrexed for malignant pleural mesothelioma (MPM). We present a case of MPM in a 77-year-old male suffering from severe NE one week after the seventeenth cycle of pemetrexed in the course of maintenance therapy for MPM, which could be treated successfully with antibiotic coverage and supportive measures. Concomitantly the patient showed a severe hyperpigmentation of his entire integument sparing the palms of both hands and the soles of his feet. After exclusion of alternative causes of skin hyperpigmentation, a pemetrexed-induced cutaneous hyperpigmentation was assumed according to two previous case reports. A combination of both pemetrexed-induced side effects in one patient has not been reported to date. AbstractNeutropenic enteritis (NE) or enterocolitis (NEC) is a rare, but potentially life-threatening side effect of neutropenia-inducing chemotherapy agents.Generally, its occurrence is attributed to leukaemia-associated chemotherapies. Two cases of NE have been reported after the appliance of pemetrexed for treatment of non-small cell lung cancers. To our knowledge, NE has never been reported due to treatment with pemetrexed for malignant pleural mesothelioma (MPM). We present a case of MPM in a 77-year-old male suffering from severe NE one week after the seventeenth cycle of pemetrexed in the course of maintenance therapy for MPM, which could be treated successfully with antibiotic coverage and supportive measures. Concomitantly the patient showed a severe hyperpigmentation of his entire integument sparing the palms of both hands and the soles of his feet. After exclusion of alternative causes of skin hyperpigmentation, a pemetrexed-induced cutaneous hyperpigmentation was assumed according to two previous case reports. A combination of both pemetrexedinduced side effects in one patient has not been reported to date.

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Neutropenic enterocolitis in adults: systematic analysis of evidence quality

Cited by 233 publications

References 139 publications

Risk of Infections in Adult Patients with Haematological Malignancies

Risk of Infections in Adult Patients with Haematological Malignancies

Ultrasound findings guided a successful hemicolectomy in a leukemic patient with neutropenic enterocolitis

Pemetrexed-induced neutropenic enteritis and severe cutaneous hyperpigmentation in a patient with malignant pleural mesothelioma

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