Imatinib-induced pericardial effusion in a child

BMJ Case Rep. 2019 Sep 11;12(9):e229975. doi: 10.1136/bcr-2019-229975.

Abstract

A 12-year-old boy presented with central chest pain, shortness of breath and type 1 respiratory failure. He had a background of graft versus host disease (GvHD), which was currently managed with imatinib therapy. A focused bedside ultrasound scan was performed revealing a large pericardial effusion. The child was referred to a tertiary paediatric cardiology centre where he underwent emergency pericardiocentesis, draining a total of 800 mL of pericardial fluid. Fluid analysis excluded infection, and with no other concerns for a GvHD flare the diagnosis of an imatinib-induced pericardial effusion was made. On terminating the therapy, the pericardial collection did not reaccumulate. Tyrosine kinase inhibitor-induced pericardial and/or pleural effusion should be considered as a differential diagnosis in paediatric patients on this therapy presenting in a similar manner.

Keywords: cardiovascular medicine; paediatrics; sickle cell disease; tyrosine kinase inhibitor; unwanted effects/adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Graft vs Host Disease / drug therapy
  • Humans
  • Imatinib Mesylate / adverse effects*
  • Male
  • Pericardial Effusion / chemically induced*
  • Pericardial Effusion / diagnosis
  • Protein Kinase Inhibitors / adverse effects*

Substances

  • Protein Kinase Inhibitors
  • Imatinib Mesylate