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Unexpected outcome (positive or negative) including adverse drug reactions
Case report
Chylothorax: complication attributed to dasatinib use
  1. Abdullah Al-abcha1,
  2. Mian Harris Iftikhar2,
  3. Fawzi Abu Rous1 and
  4. Heather Laird-Fick1
  1. 1Internal Medicine, Michigan State University, East Lansing, Michigan, USA
  2. 2Sleep Medicine, Washington University, St Louis, Missouri, USA
  1. Correspondence to Dr Abdullah Al-abcha; alabchaa{at}msu.edu

Abstract

A 63-year-old woman with a medical history of chronic myelogenous leukaemia treated with dasatinib, chronic obstructive pulmonary disease and heart failure with preserved ejection fraction presented with difficulty in breathing. Chest X-ray showed large right-sided pleural effusion, which was confirmed on a CT angiogram of the chest. Echocardiogram showed an ejection fraction of 61% with moderate to severely dilated right ventricle and right ventricular systolic pressure of 60 mm Hg. Diagnostic and therapeutic thoracentesis was performed, and 2.2 L of pleural fluid was removed. Pleural fluid analysis was consistent with chylothorax. Significant symptomatic improvement was noted after thoracentesis. In the absence of an alternate explanation, chylothorax was attributed to dasatinib, which was switched to nilotinib. This resulted in resolution of her pleural effusions.

  • unwanted effects / adverse reactions
  • respiratory medicine
  • dasatinib
  • haematology (drugs and medicines)

https://doi.org/10.1136/bcr-2019-231653

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    Footnotes

    • Contributors AA: planning the manuscript, literature search and writing the discussion part. MHI: acquisition of the consent, writing the case presentation, investigation and differential diagnosis parts. FAR: writing background, treatment and outcome and follow up parts. HL-F: supervising other authors, revising and editing the whole manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

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