A case of rare metabolic acidosis related to sorafenib therapy

Yıl 2020, Cilt: 2 Sayı: 4, 159 - 161, 23.09.2020

Muharrem Bayrak , Kenan Çadırcı

https://doi.org/10.38053/acmj.753524

Öz

Abstract: A 76-year-old female patient was followed up in the oncology clinic with a diagnosis of metastatic papillary thyroid carcinoma. Administration of Sorafenib, a vascular endothelial growth factor receptor (VEGFR) inhibitor, was initiated. Fifteen days after beginning treatment, the patient was admitted to the emergency department due to newly developed weakness, fatigue and impaired consciousness. The arterial blood gas examination of the patient revealed metabolic acidosis and the patient was admitted to the internal medicine clinic. Sorafenib therapy was discontinued, followed by administration of intravenous fluid and sodium bicarbonate therapies. Urine output and blood gas were closely monitored. Additionally, anti-acidosis tablet (2000 mg/day) treatment was started. After 5 days of treatment, routine blood gas results showed improvement and treatment was discontinued. The patient was discharged from the hospital and scheduled for follow-up at the outpatient clinic.

Anahtar Kelimeler

sorafenib, metabolic acidosis

Kaynakça

• 1-Cabanillas ME, Waguespack SG, Bronstein Y, Williams MD, Feng L, Hernandez M, et al. Treatment with tyrosine kinase inhibitors for patients with differentiated thyroid cancer: the M. D. Anderson experience. J Clin Endocrinol Metab 2010; 95:2588-95. doi: 10. 1210/ jc. 2009 -1923. 2- Marotta V, Ramundo V, Camera L, Del Prete M, Fonti R, Esposito R, et al. Sorafenib in advanced iodine-refractory differentiated thyroid cancer: efficacy, safety and exploratory analysis of role of serum thyroglobulin and FDG-PET. Clin Endocrinol (Oxf) 2013;78:760-7. doi: 10.1111/cen.12057. 3- Schlumberger MJ. Diagnostic follow-up of well-differentiated thyroid carcinoma: historical perspective and current status. J Endocrinol Invest 1999;22:3-7. 4- Chen L, Shen Y, Luo Q, Yu Y, Lu H, Zhu R. Response to sorafenib at a low dose in patients with radioiodine-refractory pulmonary metastases from papillary thyroid carcinoma. Thyroid. 2011;21:119-24. doi: 10.1089/thy.2010.0199. 5-Shoup M, Stojadinovic A, Nissan A, Ghossein RA, Freedman S, Brennan MF, et al. Prognostic indicators of outcomes in patients with distant metastases from differentiated thyroid carcinoma. J Am Coll Surg 2003;197:191-7. doi: 10.1016/S1072-7515(03)00332-6 6- Wilhelm SM, Carter C, Tang L, Wilkie D, McNabola A, Rong H, et al. BAY 43-9006 exhibits broad spectrum oral antitumor activity and targets the RAF/MEK/ERK pathway and receptor tyrosine kinases involved in tumor progression and angiogenesis. Cancer Res 2004 ;64:7099-109. doi: 10.1158/0008-5472.CAN-04-1443 7- Chrisoulidou A, Mandanas S, Margaritidou E, Mathiopoulou L, Boudina M, Georgopoulos K, et al. Treatment compliance and severe adverse events limit the use of tyrosine kinase inhibitors in refractory thyroid cancer. Onco Targets Ther 2015;8:2435-42. doi: 10.2147/OTT.S86322. 8- Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-214. doi: 10.1089/thy.2009.0110. 9-Davidson MB, Thakkar S, Hix JK, Bhandarkar ND, Wong A, Schreiber MJ. Pathophysiology, clinical consequences, and treatment of tumor lysis syndrome. Am J Med 15;116:546-54. doi: 10.1016/j.amjmed.2003.09.045 10-Huang WS, Yang CH. Sorafenib induced tumor lysis syndrome in an advanced hepatocellular carcinoma patient. World J Gastroenterol. 2009;15:4464-6. doi: 10.3748/wjg.15.4464