A-S. Vander Mijnsbrugge MD, D. Wijsmans MD, V. Maertens MD
Ibrutinib is an inhibitor of Bruton’s tyrosine kinase used in the treatment of different B-cell malignancies. We describe a case of an 82-year-old woman with known chronic lymphocytic leukaemia (CLL) treated with ibrutinib who presented to the medical department with a symptomatic pericardial and pleural effusion. Extensive investigations were performed to rule out the most common aetiologies. Diagnosis of pleuro-pericardial effusion as an infrequently reported adverse effect of ibrutinib was made. Signs, symptoms, echocardiographic and radiographic abnormalities resolved steadily with anti-inflammatory therapy, pericardiocentesis, various thoracenteses and eventually surgical pleurodesis. Therapy with ibrutinib was definitively interrupted. A similar case of an 88-year-old male patient with stage IV mantle cell lymphoma was seen a few months later. These two cases suggest a causal relationship between therapy with ibrutinib and the onset of a symptomatic pleuropericardial effusion.