PMID- 38077703
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231211
IS  - 2284-2594 (Electronic)
IS  - 2284-2594 (Linking)
VI  - 10
IP  - 12
DP  - 2023
TI  - Ponatinib-Induced Pneumonitis with Severe Acute Respiratory Distress Syndrome.
PG  - 004162
LID - 10.12890/2023_004162 [doi]
LID - 004162
AB  - Ponatinib is a third-generation tyrosine kinase inhibitor (TKI) that can 
      effectively treat patients with acute lymphoblastic leukaemia (ALL), particularly 
      those with Philadelphia chromosome-positive (Ph+ALL) subtype, who are resistant 
      or have previously received other TKIs. We report a case of a 42-year-old female 
      with Ph+ALL who was admitted to the intensive care unit with respiratory failure 
      and severe acute respiratory distress syndrome (ARDS), while on treatment with 
      ponatinib. Despite being treated with multiple antibiotics and antivirals, the 
      patient's condition continued to worsen, and pulmonary complications secondary to 
      TKI were suspected. After starting a steroid regimen, the patient's condition 
      improved drastically with resolution of the pulmonary complications. While many 
      adverse events (AEs) happen in the beginning stages of TKI treatment, certain 
      toxicities may not arise until months after therapy initiation. Cardiovascular 
      complications are the most common AE of ponatinib, including heart failure and 
      arterial hypertension. Pulmonary complications may occur, and management includes 
      drug cessation and individualised steroid therapy. In case of respiratory failure 
      without signs of infection and no improvement with antimicrobial treatment, 
      clinicians should consider the possibility of pulmonary toxicity associated with 
      ponatinib. LEARNING POINTS: Although rarely reported, ponatinib may have 
      pulmonary toxicity presenting as new onset of respiratory 
      insufficiency.Management of pulmonary complications includes adjusting or 
      discontinuation of ponatinib and simultaneous treatment with steroids.
CI  - (c) EFIM 2023.
FAU - Ferreira, Sofia Dinis
AU  - Ferreira SD
AD  - Servico de Medicina Intensiva, Hospital Dr. Nelio Mendonca, Funchal, Portugal.
FAU - Jardim, Margarida
AU  - Jardim M
AD  - Servico de Medicina Intensiva, Hospital Dr. Nelio Mendonca, Funchal, Portugal.
FAU - Camara, Margarida
AU  - Camara M
AD  - Servico de Medicina Intensiva, Hospital Dr. Nelio Mendonca, Funchal, Portugal.
FAU - Jacinto, Fernando
AU  - Jacinto F
AD  - Servico de Hematologia, Hospital Dr. Nelio Mendonca, Funchal, Portugal.
FAU - Aveiro, Fernando
AU  - Aveiro F
AD  - Servico de Hematologia, Hospital Dr. Nelio Mendonca, Funchal, Portugal.
FAU - Nobrega, Jose Julio
AU  - Nobrega JJ
AD  - Servico de Medicina Intensiva, Hospital Dr. Nelio Mendonca, Funchal, Portugal.
LA  - eng
PT  - Journal Article
DEP - 20231013
PL  - Italy
TA  - Eur J Case Rep Intern Med
JT  - European journal of case reports in internal medicine
JID - 101648453
PMC - PMC10705833
OTO - NOTNLM
OT  - ARDS
OT  - Philadelphia chromosome-positive
OT  - Ponatinib
OT  - acute lymphoblastic leukaemia
OT  - pneumonitis
COIS- Conflicts of Interests: The Authors declare that there are no competing 
      interests.
EDAT- 2023/12/11 12:42
MHDA- 2023/12/11 12:43
PMCR- 2023/10/13
CRDT- 2023/12/11 06:33
PHST- 2023/10/28 00:00 [received]
PHST- 2023/10/30 00:00 [accepted]
PHST- 2023/12/11 12:43 [medline]
PHST- 2023/12/11 12:42 [pubmed]
PHST- 2023/12/11 06:33 [entrez]
PHST- 2023/10/13 00:00 [pmc-release]
AID - 4162 [pii]
AID - 10.12890/2023_004162 [doi]
PST - epublish
SO  - Eur J Case Rep Intern Med. 2023 Oct 13;10(12):004162. doi: 10.12890/2023_004162. 
      eCollection 2023.