Title:Sunitinib Induced Disseminated Intravascular Coagulation after COVID-19
Infection in a Patient with Neuroendocrine Tumor: A Case Report
Volume: 5
Author(s): Mona Tareen, Julieta O Zuluaga, Maroun El khoury, Sameh Salem and Faraz Khan*
Affiliation:
- Department of Hematology/Oncology, American Hospital, Dubai, United Arab Emirates
Keywords:
DIC, COVID-19, Sunitinib, Drug, Neuroendocrine, Carcinoma.
Abstract:
Background:
Disseminated intravascular coagulation (DIC) is a known complication of malignancy. Drug-induced DIC is also reported. Sunitinib is a tyrosine
kinase inhibitor approved as an oral targeted therapy in the treatment of different cancers. Here we present a case study of disseminated
intravascular coagulation following the administration of Sunitinib after COVID-19 infection in a patient diagnosed with metastatic
neuroendocrine tumor of the lung.
Case Report:
A 35-year-old male patient with a known metastatic lung neuroendocrine tumor (NET) who was treated with Sunitinib for many years with partial
response and tolerating the treatment well-developed recurrent DIC on Sunitinib after COVID-19 infection.
Discussion:
COVID-19 infection is reported to be associated with endothelial injury and inflammation. Vascular endothelial growth factor (VEGF) receptors
have a role in the protection and modulation of endothelium. Sunitinib is a multikinase inhibitor with anti- VEGF effect. It is possible that
endothelial injury after COVID-19 may have triggered recurrent DIC in this patient who had previously tolerated the same drug without problems.
Conclusion:
DIC may be underreported especially with antineoplastics having anti-VEGF effects. Potential risk, interaction, and association with COVID-19
infection in the Era of the pandemic are unclear but warrants further research, and drug-induced DIC should be considered in the differential
diagnosis of such cases.
