%0 Journal Article
%T Cardiac tamponade and graft versus host disease: one more reason to remember
%A Alessandra Battezzi
%A Laura Parisella
%A Luigi Vetrugno
%A Mattia Bernardinetti
%A Serana Tomasino
%A Tiziana Bove
%J Tumori Journal
%@ 2038-2529
%D 2018
%R 10.1177/0300891618794890
%X In patients with cutaneous graft versus host disease (GvHD) that is resistant to traditional steroid therapy, imatinib is a first-generation tyrosine kinase inhibitor that seems to be a viable option. However, its antifibrotic activity can be associated with serosal inflammation and fluid retention. We report a case of an adult patient who, after allogenic hematopoietic stem cell transplantation, developed a GvHD treated with imatinib at low dosage, followed by multiorgan failure. Clinical examination and cardiac ultrasound were unable to clearly recognize the low cardiac output state; laboratory analysis, filling pressure, and computed tomography examination clarified the correct diagnosis. Low cardiac output state, secondary to pericardial effusion, is a diagnostic challenge. However, the association of four elements can help in its early recognition: increase in lactate levels and central venous pressure, associated with a low central venous saturation and a low brain natriuretic peptide level. Pericardial effusion with cardiac tamponade is a difficult diagnosis even with ultrasound. Lactate levels, central venous pressure plus venous saturation, and brain natriuretic peptide could help in early detection
%K Cardiac tamponade
%K central venous pressure
%K graft versus host disease
%U https://journals.sagepub.com/doi/full/10.1177/0300891618794890