전이성 대장암 환자에서 Bevacizumab을 사용 후 대장 내시경으로 확인된 허혈성 대장염 1예
Bevacizumab-associated Ischemic Colitis Proven by Colonoscopy
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초록
베바시주맙은 여러 고형암 치료를 위해서 사용되고 있는혈관 내피세포 단일클론 항체이다. 베바시주맙은 기존 화학요법제 보다 낮은 빈도로 부작용을 보이지만, 소화관 천공은매우 치명적인 부작용이다. 베바시주맙 관련 소화관 천공은장관내 혈관 구조의 손상과 관련이 있다. 그러나 허혈성 장염은 비특이적으로 증상을 보여서 증상만으로 진단이 어려운 질환이다. 우리는 베바시주맙으로 치료받고 대장 내시경과 병리학적으로 확인된 허혈성 장염으로 진단되었고, 일반적인 지지요법을 통해서 호전된 56세 여자 환자 증례를 보고합니다.
Abstract
Bevacizumab is a monoclonal antibody against vascular endothelial growth factor widely used to treat several types of solid tumor. Although bevacizumab has fewer adverse effects than conventional chemotherapy agents, several serious events have been reported. Gastrointestinal perforation is an infrequent but potentially fatal side-effect of bevacizumab. The major mechanism of bevacizumab-associated gastrointestinal perforation is damage to the intestinal vasculature. However, preceding ischemic colitis is difficult to diagnose due to its non-specific symptoms. We report a case of a 56-year-old male with bevacizumab-associated ischemic colitis proven by colonoscopy and pathologic findings. The patient’s condition improved after general supportive care including bowel rest, intravenous fluids, and intravenous antibiotics. No similar event has been reported since he resumed chemotherapy without bevacizumab.
참고문헌 (10)
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