Pulmonary arterial hypertension in a chronic lymphocytic leukemia patient in treatment with rituximab

Montrone, Deodata; Correale, Michele; Franzese, Maria Grazia; Ieva, Riccardo; Capalbo, Silvana

doi:10.2459/jcm.0b013e3283621adf

Cited by 7 publications

(2 citation statements)

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“…In a presumed case of iPAH, rituximab co-treatment with chemotherapy for lymphoma lead to symptom resolution, and PAH in the setting of Castleman lymphoma was also noted to respond to rituximab [63,85]. However, in two instances, rituximab use was associated with the development of PH [79,80].…”

Section: Discussionmentioning

confidence: 98%

Severe but reversible pulmonary hypertension in scleromyxedema and multiple myeloma: a case report

et al. 2020

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Background: Scleromyxedema is a progressive, systemic connective tissue disorder characterized by fibro-mucous skin lesions and increased serum monoclonal immunoglobulin levels. Pulmonary involvement occurs in a subset of patients, though the overall prevalence of pulmonary lesions in scleromyxedema is unknown. Since pulmonary hypertension presumably occurs in these patients due to disease progression and development of additional conditions, treatment of the underlying plasma cell dyscrasia and connective tissue disorder may improve pulmonary hypertension symptoms. Case presentation: An elderly patient with scleromyxedema developed pulmonary hypertension refractory to vasodilator and diuretic therapy and subsequently multiple myeloma that responded to a combination therapy of bortezomib, cyclophosphamide, and dexamethasone treatment. Conclusions: Treatment of the underlying disease(s) that contributed to pulmonary hypertension development with anti-neoplastic agents like bortezomib may improve cardiopulmonary symptoms secondary to reducing abnormal blood cell counts and paraprotein levels.

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Section: Discussionmentioning

confidence: 98%

Severe but reversible pulmonary hypertension in scleromyxedema and multiple myeloma: a case report

et al. 2020

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“…and diastolic dysfunction [19]. Cardiovascular toxicity due to rituximab occurs in 8% of the patients; it includes ventricular and supraventricular tachycardia, coronary vasospasm, Takotsubo cardiomyopathy but also arterial pulmonary hypertension with right heart failure and preserved systolic LV function [20][21][22].…”

Section: Conflict Of Interestmentioning

confidence: 99%

Acute right heart failure in Waldenström macroglobulinemia: A case report

Memis

Balinisteanu

Găman

et al. 2022

Romanian Journal of Cardiology

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Waldenström macroglobulinemia (WM) is a low-grade B-cell clonal disorder with lymphoplasmacytic bone marrow involvement and monoclonal immunoglobulin M (IgM) with poor prognosis. Clinical features include anemia, thrombocytopenia, hepatosplenomegaly, lymphadenopathy and hyperviscosity. We report the case of a 42-year-old male who presented with unexplained weight loss. The diagnosis of WM was established after morphological and immunohistochemical examination of the patient's bone marrow along with an elevated serum IgM level. He started chemotherapy with cyclophosphamide, bortezomib, dexamethasone and, four months later, rituximab was added. Five months later the patient presented with relapse of the hematological disease, hyperviscosity syndrome and acute right heart failure. Echocardiography showed a dilated right ventricle with decreased global systolic function and severe systolic pulmonary artery pressure, with normal left cardiac function and volumes. Despite maximal medical therapy, the patient died in day six of hospitalization. This case is distinguished by the rapidly evolving rare haematological cancer despite optimal chemotherapy and a multidisciplinary approach associated with chemotherapy-related late right heart dysfunction in a young man, without any cardiovascular risk factors or previous myocardial disease.

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Rituximab

2015

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Pulmonary arterial hypertension in a chronic lymphocytic leukemia patient in treatment with rituximab

Cited by 7 publications

References 1 publication

Severe but reversible pulmonary hypertension in scleromyxedema and multiple myeloma: a case report

Severe but reversible pulmonary hypertension in scleromyxedema and multiple myeloma: a case report

Acute right heart failure in Waldenström macroglobulinemia: A case report

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