Reactions 1704, p135 - 2 Jun 2018 Transient ischaemic attack: case report A 34-year-old woman developed transient ischaemic attack during treatment with lenalidomide and dexamethasone for POEMS syndrome [routes and dosages not stated]. The woman was hospitalised due to transient ischaemic attack. Three months ago, she was diagnosed with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. Seven days prior to current hospitalisation, her treatment was started with lenalidomide and dexamethasone for POEMS syndrome along with aspirin for prevention of thrombosis. On admission, she had transient aphasia and transient right haemiparesis. She did not have any vascular risk factors. Blood tests revealed slightly elevated C-reactive protein and D-dimer before and after lenalidomide and dexamethasone therapy. A CT angiography and MRI showed stenosis of bilateral internal carotid arteries and the right middle cerebral artery. The woman’s lenalidomide and dexamethasone were discontinued. Ozagrel was added to the therapy along with aspirin. On day 12, she developed dyspnoea due to pleural effusion. Therefore, lenalidomide and dexamethasone therapy was re-initiated. However, on day 15, she again developed transient aphasia. Heparin was added for anti-thrombotic therapy. On day 17, transient left haemiparesis was observed. A diagnosis of repeated transient cerebrovascular ischaemic attack was made. Thereafter, treatment with lenalidomide and dexamethasone was switched to carfilzomib and dexamethasone, after which no relapse of the disease was observed. Author comment: "She developed transient ischemic attack after the introduction of lenalidomide plus dexamethasone (Rd) therapy despite no vascular risk factors." Mitsutake A, et al. Lenalidomide-Induced Ischemic Cerebrovascular Disease in Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Gammopathy, and Skin Changes Syndrome. Journal of Stroke and Cerebrovascular Diseases 27: e102-e103, No. 6, Jun 2018. Available from: URL: http://doi.org/10.1016/ j.jstrokecerebrovasdis.2017.12.039 - Japan 803323909 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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