Ogilvie's syndrome in acute myeloid leukemia: pharmacological approach with neostigmine

Ann Hematol. 2001 Oct;80(10):614-6. doi: 10.1007/s002770100337.

Abstract

Acute colonic pseudo-obstruction, the so-called Ogilvie's syndrome, is a rare and life-threatening digestive complication usually observed in critically ill patients. It is characterized by signs of large-bowel obstruction, without a mechanical cause, and has been reported in various settings, including acute leukemias as a complication of neutropenic enterocolitis after intensive chemotherapy. We describe the case of a young woman who, during the neutropenic phase following autologous bone marrow transplantation for relapsed acute myeloid leukemia, developed neutropenic enterocolitis complicated by an acute pseudo-obstruction of descendent colon and sigma. This process was associated with sepsis and resolved with conservative therapy of the underlying condition, using granulocyte colony-stimulating factor and intravenous neostigmine. We discuss the management of this rare syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation / adverse effects
  • Cholinesterase Inhibitors / therapeutic use*
  • Colonic Pseudo-Obstruction / diagnostic imaging
  • Colonic Pseudo-Obstruction / drug therapy*
  • Colonic Pseudo-Obstruction / etiology*
  • Enterocolitis / complications
  • Female
  • Humans
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / therapy
  • Neostigmine / therapeutic use*
  • Neutropenia / complications
  • Recurrence
  • Ultrasonography

Substances

  • Cholinesterase Inhibitors
  • Neostigmine