Acute Cyclophosphamide Hemorrhagic Myopericarditis: Dilemma Case Report, Literature Review and Proposed Diagnostic Criteria
Cyclophosphamide is a potent DNA alkylating agent used in chemotherapy and immunosuppression. Although an old agent, its use in the present day has expanded for cases of refractory autoimmune disease. In this report, a case of haemorrhagic myopericarditis resulting from high-dose cyclophosphamide...
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/6758/15054_CE[Ra1]_F(AK)_PF1(EKAK)_PFA(NC_AK)_PF2(PAG).pdf |
| Summary: | Cyclophosphamide is a potent DNA alkylating agent used in chemotherapy and immunosuppression. Although an old agent, its use
in the present day has expanded for cases of refractory autoimmune disease. In this report, a case of haemorrhagic myopericarditis
resulting from high-dose cyclophosphamide for chronic inflammatory demyelinating polyneuropathy is presented. The patient had
no predisposing cardiovascular risk factors and a structurally normal heart on previous echocardiogram. Following administration of
high-dose cyclophosphamide, the patient developed acute congestive heart failure. Serial echocardiography demonstrated pericardial
effusion, myocardial thickening, and progressive right ventricular dysfunction. Histopathology on autopsy revealed acute myocardial
necrosis, intra-myocardial extravasation of blood, fibrin, and fibrin-platelet microthrombi compatible with the diagnosis of haemorrhagic
myopericarditis. The ante-mortem diagnostic dilemma is described to emphasize the need for pattern recognition and clinical criteria
for diagnosis. Subsequent comprehensive literature review was performed to identify features that will facilitate earlier diagnosis of
haemorrhagic myopericarditis by healthcare providers. |
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| ISSN: | 2249-782X 0973-709X |