Post-chemotherapy arthralgia and arthritis in lung cancer

Aref H Amiri; Soleiman Jaferian

doi:10.4103/2278-330X.103715

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Mini Symposium on Supportive Care: Original Article

01 (

); 72-75

doi:

10.4103/2278-330X.103715

Post-chemotherapy arthralgia and arthritis in lung cancer

Aref H Amiri^1,, Soleiman Jaferian²

1 Department of Rheumatology, Imam Khomeini hospital, Mazandaran University of Medical Sciences, Sari

2 Department of Internal Medicine, Shohada Hospital, Lorestan University of Medical Sciences, Koramabad, Iran

*Corresponding author: Aref Hosseinian Amiri. aref104@gmail.com

Published: 2020-12-30

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Abstract

Objective: Evaluate the characteristics of arthritis, arthralgia and musculoskeletal pain after chemotherapy in patients with lung cancer. Materials and Methods: In this study, we evaluate the characteristics of 17 patients with joint symptoms following receiving chemotherapy for lung cancer. Demographic information of patients including sex, age, time of rheumatologic findings after starting of chemotherapy, time of improvement after starting of medication, and relevant laboratory findings for each patient. Results: A total of seventeen patients (six women with mean age 41.2 ± 5.2 years and 11 men with mean age 42.5 ± 8.2) that received standard chemotherapy for lung cancer according to stage of disease. Joint symptoms usually began about seven months after the first session of chemotherapy. Patients had an average of two tender joints and 1 hr of morning stiffness. Four patients were positive for anti-nuclear antibody, and none of patient was positive for rheumatoid factor. Non-steroidal anti-inflammatory drugs, disease modifying anti-rheumatic drugs (DMARD), corticosteroids, and venlafaxine were prescribed. Four patients did not show an improvement. Follow-up was available for all patients. 11 patients showed favorable responses, characterized by a significant decrease (more than 50%) in morning stiffness, pain, and tender joint counts after a mean of three months’ treatment. Two patients had complete resolution of symptoms and did not required further medications for arthritis, arthralgia or musculoskeletal pain. Conclusion: Chemotherapy-related arthropathy in lung cancer is not uncommon. Early treatment with NSAID, DMARD, and corticosteroids is effective in the majority of patients.

Keywords

References

Chakravarty E, Genovese MC. Rheumatic syndromes associated with malignancy. Curr Opin Rheumatol 2003;15:35-43.
Abu-Shakra M, Buskila D, Ehrenfeld M, Conrad K, Shoenfeld Y. Cancer and autoimmunity: Autoimmune and rheumatic features in patients with malignancies. Ann Rheum Dis 2001;60:433-41.
Leandro MJ, Isenberg DA. Rheumatic diseases and malignancy: is there an association? Scand J Rheumatol 2001;30:185-8.
Naschitz JE, Rosner I, Rozenbaum M, Zuckerman E, Yeshurun D. Rheumatic syndromes: Clues to occult neoplasia. Semin Arthritis Rheum 1999;29:43-55.
Seda H, Alarcón GS. Musculoskeletal syndromes associated with malignancies. Curr Opin Rheumatol 1995;7:48-53.
Massarotti EM, Liu NY, Mier J, Atkins MB. Chronic inflammatory arthritis after treatment with high-dose interleukin-2 for malignancy. Am J Med 1992;92:693-7.
Jawad AS, Kahn L, Copland RF, Henderson DC, Abdul-Ahad AK. Reactive arthritis associated with Bacillus Calmette-Guerin immunotherapy for carcinoma of the bladder: A report of two cases. Br J Rheumatol 1993; 32:1018-20.
Kurzrock R, Cohen PR, Markowitz A. Clinical manifestations of vasculitis in patients with solid tumors: A case report and review of the literature. Arch Intern Med 1994;154:334-40.
Rosentein ED, Kramer N, Leitner SP, Michaelson RA. Exacerbation of rheumatoid arthritis after termination of chemotherapy for breast carcinoma. J Rheumatol 1996;23:1988-90.
Loprinzi CL, Duffy J, Ingle JN. Post chemotherapy rheumatism. J Clin Oncol 1993;11:768-70.
Raderer M, Scheithauer W. Post chemotherapy rheumatism following adjuvant therapy for ovarian cancer. Scand J Rheumatol 1994;23:291-2.
Smith DE. Additional cases of post chemotherapy rheumatism. J Clin Oncol 1993;11:1625-6.
Siegel JE. Post chemotherapy rheumatism′s this a menopausal symptom? J Clin Oncol 1993;11:2051.
Michl I, Zielinski CC. More post chemotherapy rheumatism. J Clin Oncol 1993;11:2051-2.
Warner E, Keshavjee al-N, Shupak R, Bellini A. Rheumatic symptoms following adjuvant therapy for breast cancer. Am J Clin Oncol 1997; 20:322-6.
Amft N, D′Cruz D. Post chemotherapy connective tissue disease-more than just rheumatism? Lupus 1996;5:255-6.
Sperandio P, Tomio P, Oliver RT, Fiorentino MV, Pagano F. Gonadal atrophy as a cause of thymic hyperplasia after chemotherapy. Br J Cancer 1996;74:991-2.
Kim MJ, Ye YM, Park HS, Suh CH. Chemotherapy-related arthropathy. J Rheumatol 2006;33:1364-8.
Creamer P, Lim K, George E, Dieppe P. Acute inflammatory polyarthritis in association with tamoxifen. Br J Rheumatol 1994;33;583-5.

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[1] Chakravarty E, Genovese MC. Rheumatic syndromes associated with malignancy. Curr Opin Rheumatol 2003;15:35-43.

[2] Abu-Shakra M, Buskila D, Ehrenfeld M, Conrad K, Shoenfeld Y. Cancer and autoimmunity: Autoimmune and rheumatic features in patients with malignancies. Ann Rheum Dis 2001;60:433-41.

[3] Leandro MJ, Isenberg DA. Rheumatic diseases and malignancy: is there an association? Scand J Rheumatol 2001;30:185-8.

[4] Naschitz JE, Rosner I, Rozenbaum M, Zuckerman E, Yeshurun D. Rheumatic syndromes: Clues to occult neoplasia. Semin Arthritis Rheum 1999;29:43-55.

[5] Seda H, Alarcón GS. Musculoskeletal syndromes associated with malignancies. Curr Opin Rheumatol 1995;7:48-53.

[6] Massarotti EM, Liu NY, Mier J, Atkins MB. Chronic inflammatory arthritis after treatment with high-dose interleukin-2 for malignancy. Am J Med 1992;92:693-7.

[7] Jawad AS, Kahn L, Copland RF, Henderson DC, Abdul-Ahad AK. Reactive arthritis associated with Bacillus Calmette-Guerin immunotherapy for carcinoma of the bladder: A report of two cases. Br J Rheumatol 1993; 32:1018-20.

[8] Kurzrock R, Cohen PR, Markowitz A. Clinical manifestations of vasculitis in patients with solid tumors: A case report and review of the literature. Arch Intern Med 1994;154:334-40.

[9] Rosentein ED, Kramer N, Leitner SP, Michaelson RA. Exacerbation of rheumatoid arthritis after termination of chemotherapy for breast carcinoma. J Rheumatol 1996;23:1988-90.

[10] Loprinzi CL, Duffy J, Ingle JN. Post chemotherapy rheumatism. J Clin Oncol 1993;11:768-70.

[11] Raderer M, Scheithauer W. Post chemotherapy rheumatism following adjuvant therapy for ovarian cancer. Scand J Rheumatol 1994;23:291-2.

[12] Smith DE. Additional cases of post chemotherapy rheumatism. J Clin Oncol 1993;11:1625-6.

[13] Siegel JE. Post chemotherapy rheumatism′s this a menopausal symptom? J Clin Oncol 1993;11:2051.

[14] Michl I, Zielinski CC. More post chemotherapy rheumatism. J Clin Oncol 1993;11:2051-2.

[15] Warner E, Keshavjee al-N, Shupak R, Bellini A. Rheumatic symptoms following adjuvant therapy for breast cancer. Am J Clin Oncol 1997; 20:322-6.

[16] Amft N, D′Cruz D. Post chemotherapy connective tissue disease-more than just rheumatism? Lupus 1996;5:255-6.

[17] Sperandio P, Tomio P, Oliver RT, Fiorentino MV, Pagano F. Gonadal atrophy as a cause of thymic hyperplasia after chemotherapy. Br J Cancer 1996;74:991-2.

[18] Kim MJ, Ye YM, Park HS, Suh CH. Chemotherapy-related arthropathy. J Rheumatol 2006;33:1364-8.

[19] Creamer P, Lim K, George E, Dieppe P. Acute inflammatory polyarthritis in association with tamoxifen. Br J Rheumatol 1994;33;583-5.

Post-chemotherapy arthralgia and arthritis in lung cancer

Abstract

Abstract

Keywords

References

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