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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Polymyalgia rheumatica development in a patient under PI3K inhibitor therapy for chronic lymphocytic leukaemia
  1. Sanah Sajawal1,
  2. Sarah L Mackie2,
  3. Peter Hillmen3,
  4. Dennis McGonagle4
  1. 1Chapel Allerton Hospital, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
  2. 2Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
  3. 3Department of Haematology, St James’s University Hospital, Leeds, UK
  4. 4NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
  1. Correspondence to Dr Sanah Sajawal, ssajawal{at}nhs.net

Summary

We report a patient with chronic lymphocytic leukaemia (CLL) who was treated with idelalisib, a PI3Kδ inhibitor with rituximab. After 20 weeks of treatment, the patient developed classical signs and symptoms of polymyalgia rheumatica (PMR) in association with an elevated C reactive protein of 74 mg/L. After 2 weeks of prednisolone 15 mg daily symptoms had resolved and acute phase markers normalised. To our knowledge, this is the first report of PMR developing as a complication of PI3Kδ inhibitor treatment of CLL.

  • musculoskeletal syndromes
  • haematology (drugs And Medicines)

https://doi.org/10.1136/bcr-2017-221065

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    Footnotes

    • Contributors SS obtained consent from the next of kin; contributed to the planning, literature search and collated the required patient information from the notes; helped to write the summary, background, case presentation, discussion and learning points sections of the manuscript. SS was also involved in the referencing and proof-reading of the manuscript. SLM contributed to the literature search, writing of the background, case presentation, discussion and learning points sections of the manuscript and also helped with referencing and proof-reading of the manuscript. PH contributed to the literature search, writing of the background, case presentation, discussion and learning points sections of the manuscript and also helped with referencing, proof-reading and contacting Gilead informing them of the case report. DMG contributed to the planning, literature search and collated the required patient information from the notes, helped to write the summary, background, case presentation, discussion and learning points sections of the manuscript and also helped with referencing and proof-reading of the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.