Barrett, Stevi

ABSTRACT Uvular necrosis is a potential etiology of postesophagogastroduodenoscopy persistent sore throat and odynophagia, and physicians should be alert to the possibility of this potential complication. Diagnosis is clinical and can be made on the basis of symptoms and characteristic findings on oropharyngeal examination. It has a benign course with an overall good clinical outcome. Conservative symptomatic management is the treatment of choice, and full recovery can be expected in 2 weeks. Keeping oropharyngeal instruments and ventilation tubes to the side of the midline, avoidance of blind suctioning, and decreasing the power of suction devices are some of the measures, which might reduce the risk of intraprocedure uvular injury. In addition, it is important to note that the risk of injury is higher in some individuals, for instance, patients with a long uvula, and it might be beneficial to take extra precautions in these patients.

ABSTRACT Novel chemotherapeutic agents are developed to treat recurrent/relapsed lymphoid malignancies. Umbralisib, a novel phosphatidylinositol 3-kinase inhibitor with a selective isoform binding, has shown an improved efficacy and safety profile in clinical trials. Immune-mediated colitis, a frequently observed dose-limiting adverse event of phosphatidylinositol 3-kinase inhibitors, has been mostly observed at supratherapeutic doses in the trials, with grade 1 or 2 diarrhea being the most common adverse event at the therapeutic dose (800 mg PO QD). We present a grade-3 colitis that can be attributed to umbralisib-mediated immune toxicity in a patient with chronic lymphocytic leukemia at the therapeutic dose.