Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT
High-concentrated amino acid solution is used to protect the kidneys during peptide receptor radionuclide therapy (PPRT) in patients with neuroendocrine tumors (NETs). Extravasation of the solution can cause cutaneous complications. In this study, we described a 66-year-old man with metastatic medul...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Tomography |
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| Online Access: | https://www.mdpi.com/2379-139X/8/1/29 |
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| author | Chaninart Sakulpisuti Wichana Chamroonrat Supatporn Tepmongkol |
| author_facet | Chaninart Sakulpisuti Wichana Chamroonrat Supatporn Tepmongkol |
| author_sort | Chaninart Sakulpisuti |
| collection | DOAJ |
| description | High-concentrated amino acid solution is used to protect the kidneys during peptide receptor radionuclide therapy (PPRT) in patients with neuroendocrine tumors (NETs). Extravasation of the solution can cause cutaneous complications. In this study, we described a 66-year-old man with metastatic medullary thyroid cancer and a 32-year-old woman with metastatic pancreatic NET who developed cutaneous lesions caused by the extravasation of an amino acid solution (25 g of lysine and 25 g of arginine in 1 L of normal saline) during PRRT with [<sup>177</sup>Lu]Lu-DOTA-TATE. Both were treated conservatively, and these cutaneous lesions gradually improved. The patient with metastatic pancreatic NET rejected the amino acid infusion in subsequent cycles of PRRT and therefore received [<sup>177</sup>Lu]Lu-DOTA-TATE alone, and her serum creatinine level and estimated glomerular filtration rate (eGFR) remained normal for 2 months after the last treatment. These two cases revealed cutaneous complications resulting from high-concentrated amino acid solution during PRRT because of hyperosmolarity. Health care providers should be aware of this complication to ensure its prevention and appropriate management. Preserved renal function was demonstrated after [<sup>177</sup>Lu]Lu-DOTA-TATE treatment in the absence of the infusion of a high-concentrated amino acid solution. However, long-term follow-up of renal function is suggested. |
| first_indexed | 2024-03-09T20:56:41Z |
| format | Article |
| id | doaj.art-a380124d10c94d9b82468ee630d4e674 |
| institution | Directory Open Access Journal |
| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-03-09T20:56:41Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-a380124d10c94d9b82468ee630d4e6742023-11-23T22:19:40ZengMDPI AGTomography2379-13812379-139X2022-02-018135636310.3390/tomography8010029Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRTChaninart Sakulpisuti0Wichana Chamroonrat1Supatporn Tepmongkol2Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDivision of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDivision of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandHigh-concentrated amino acid solution is used to protect the kidneys during peptide receptor radionuclide therapy (PPRT) in patients with neuroendocrine tumors (NETs). Extravasation of the solution can cause cutaneous complications. In this study, we described a 66-year-old man with metastatic medullary thyroid cancer and a 32-year-old woman with metastatic pancreatic NET who developed cutaneous lesions caused by the extravasation of an amino acid solution (25 g of lysine and 25 g of arginine in 1 L of normal saline) during PRRT with [<sup>177</sup>Lu]Lu-DOTA-TATE. Both were treated conservatively, and these cutaneous lesions gradually improved. The patient with metastatic pancreatic NET rejected the amino acid infusion in subsequent cycles of PRRT and therefore received [<sup>177</sup>Lu]Lu-DOTA-TATE alone, and her serum creatinine level and estimated glomerular filtration rate (eGFR) remained normal for 2 months after the last treatment. These two cases revealed cutaneous complications resulting from high-concentrated amino acid solution during PRRT because of hyperosmolarity. Health care providers should be aware of this complication to ensure its prevention and appropriate management. Preserved renal function was demonstrated after [<sup>177</sup>Lu]Lu-DOTA-TATE treatment in the absence of the infusion of a high-concentrated amino acid solution. However, long-term follow-up of renal function is suggested.https://www.mdpi.com/2379-139X/8/1/29peptide receptor radionuclide therapy (PRRT)extravasationamino acidcutaneous lesion |
| spellingShingle | Chaninart Sakulpisuti Wichana Chamroonrat Supatporn Tepmongkol Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT Tomography peptide receptor radionuclide therapy (PRRT) extravasation amino acid cutaneous lesion |
| title | Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT |
| title_full | Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT |
| title_fullStr | Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT |
| title_full_unstemmed | Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT |
| title_short | Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT |
| title_sort | cutaneous management after extravasation of high concentrated amino acid solution administered for renal protection in prrt |
| topic | peptide receptor radionuclide therapy (PRRT) extravasation amino acid cutaneous lesion |
| url | https://www.mdpi.com/2379-139X/8/1/29 |
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