[Severe systemic vasculitis induced by ibrutinib]

Rev Med Interne. 2024 Jan;45(1):13-16. doi: 10.1016/j.revmed.2023.10.448. Epub 2023 Nov 10.
[Article in French]

Abstract

Introduction: The specific cutaneous toxicity of Bruton's tyrosine kinase inhibitors is poorly described. We report a case of severe systemic vasculitis induced by ibrutinib.

Observation: A 73-year-old woman with chronic lymphocytic leukemia was treated with ibrutinib. Eighteen months after treatment onset, ulceronecrotic lesions on toes and tongue occurred. Skin biopsy found vasculitis of small and medium vessels. Biologic tests were negative. This vasculitis was refractory to systemic corticosteroid therapy and azathioprine. Ibrutinib was stopped on the hypothesis of drug-induced vasculitis. Skin lesions improved after discontinuation of ibrutinib.

Conclusion: The mechanism of action of ibrutinib does not explain the occurrence of vasculitis and an immunoallergic mechanism is suspected.

Keywords: Ibrutinib; Inhibiteurs de tyrosine kinase; Tyrosine kinase inhibitors; Vascularite; Vasculitis.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adenine / analogs & derivatives*
  • Aged
  • Female
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell* / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell* / drug therapy
  • Piperidines
  • Protein Kinase Inhibitors / adverse effects
  • Systemic Vasculitis*
  • Vasculitis* / chemically induced
  • Vasculitis* / diagnosis

Substances

  • ibrutinib
  • Piperidines
  • Protein Kinase Inhibitors
  • Adenine