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Gemcitabine-induced digital ischaemia in a patient with metastatic breast cancer
  1. Abdul Moiz Khan1,
  2. Lubina Arjyal1,
  3. Lelas Shamaileh1 and
  4. Michael Simon1,2
  1. 1Hematology and Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
  2. 2Oncology, Wayne State University, Detroit, Michigan, USA
  1. Correspondence to Dr Michael Simon; simonm{at}


A woman in her 50s with HER2 (human epidermal growth factor receptor 2) positive, estrogen/progesterone receptor negative, metastatic invasive ductal carcinoma of the breast, presented with acral cyanosis and severe throbbing pain after recent administration of gemcitabine. She was treated with aspirin, heparin, amlodipine, topical nitroglycerin and analgesics. Gemcitabine was discontinued permanently. She had a gradual recovery except for a small necrotic area over the right 4th digit. However, surgical intervention was avoided.

  • Breast cancer
  • Unwanted effects / adverse reactions
  • Safety
  • Vasculitis

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  • Contributors AMK is the primary author of the case report who contributed to all the sections. LA and LS helped with writing the case presentation. MS is the primary oncologist of the patient, who supervised the whole process of manuscript writing. All the authors had an adequate contribution to merit authorship.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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