Scientific letter
Fever induced by hydroxycarbamide
Fiebre por hidroxiurea
Eva Lizarralde Palacios, Alfonso Gutiérrez Macías
, Mayte Rámiz Martínez, Mikel Escalante Boleas
Corresponding author
Servicio de Medicina Interna, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain
Read
1
Timeswas read the article
0
Total PDF
1
Total HTML
Share statistics
array:24 [ "pii" => "S2387020616300365" "issn" => "23870206" "doi" => "10.1016/j.medcle.2016.04.015" "estado" => "S300" "fechaPublicacion" => "2015-12-07" "aid" => "3244" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2015" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2015;145:505-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S002577531500086X" "issn" => "00257753" "doi" => "10.1016/j.medcli.2015.01.022" "estado" => "S300" "fechaPublicacion" => "2015-12-07" "aid" => "3244" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2015;145:505-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 19 "formatos" => array:2 [ "HTML" => 9 "PDF" => 10 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Fiebre por hidroxiurea" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "505" "paginaFinal" => "506" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Fever induced by hydroxycarbamide" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eva Lizarralde Palacios, Alfonso Gutiérrez Macías, Mayte Rámiz Martínez, Mikel Escalante Boleas" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Eva" "apellidos" => "Lizarralde Palacios" ] 1 => array:2 [ "nombre" => "Alfonso" "apellidos" => "Gutiérrez Macías" ] 2 => array:2 [ "nombre" => "Mayte" "apellidos" => "Rámiz Martínez" ] 3 => array:2 [ "nombre" => "Mikel" "apellidos" => "Escalante Boleas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020616300365" "doi" => "10.1016/j.medcle.2016.04.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616300365?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531500086X?idApp=UINPBA00004N" "url" => "/00257753/0000014500000011/v1_201511240045/S002577531500086X/v1_201511240045/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020616300353" "issn" => "23870206" "doi" => "10.1016/j.medcle.2016.04.014" "estado" => "S300" "fechaPublicacion" => "2015-12-07" "aid" => "3250" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2015;145:507-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Recurrent diffuse alveolar hemorrhage in systemic lupus erythematosus treated with rituximab and immunoglobulins" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "507" "paginaFinal" => "508" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento con rituximab e inmunoglobulinas en la hemorragia alveolar difusa recurrente en lupus eritematoso sistémico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Águeda Prior-Español, Melania Martínez-Morillo, Anne Riveros-Frutos, Alejandro Olivé" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Águeda" "apellidos" => "Prior-Español" ] 1 => array:2 [ "nombre" => "Melania" "apellidos" => "Martínez-Morillo" ] 2 => array:2 [ "nombre" => "Anne" "apellidos" => "Riveros-Frutos" ] 3 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Olivé" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775315001086" "doi" => "10.1016/j.medcli.2015.02.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775315001086?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616300353?idApp=UINPBA00004N" "url" => "/23870206/0000014500000011/v1_201604300039/S2387020616300353/v1_201604300039/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020616300390" "issn" => "23870206" "doi" => "10.1016/j.medcle.2015.01.003" "estado" => "S300" "fechaPublicacion" => "2015-12-07" "aid" => "3209" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2015;145:504-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Encephalitis associated with anti-NMDA antibodies" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "504" "paginaFinal" => "505" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Encefalitis asociada a anticuerpos contra el receptor de NMDA" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rosa Escudero Sánchez, María Teresa Montojo Villasanta, María Isabel González Anglada" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Rosa" "apellidos" => "Escudero Sánchez" ] 1 => array:2 [ "nombre" => "María Teresa" "apellidos" => "Montojo Villasanta" ] 2 => array:2 [ "nombre" => "María Isabel" "apellidos" => "González Anglada" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775315000299" "doi" => "10.1016/j.medcli.2015.01.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775315000299?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616300390?idApp=UINPBA00004N" "url" => "/23870206/0000014500000011/v1_201604300039/S2387020616300390/v1_201604300039/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Fever induced by hydroxycarbamide" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Dear Editor</span>," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "505" "paginaFinal" => "506" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Eva Lizarralde Palacios, Alfonso Gutiérrez Macías, Mayte Rámiz Martínez, Mikel Escalante Boleas" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Eva" "apellidos" => "Lizarralde Palacios" ] 1 => array:4 [ "nombre" => "Alfonso" "apellidos" => "Gutiérrez Macías" "email" => array:1 [ 0 => "alguma6725@outlook.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "Mayte" "apellidos" => "Rámiz Martínez" ] 3 => array:2 [ "nombre" => "Mikel" "apellidos" => "Escalante Boleas" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fiebre por hidroxiurea" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Drug-induced fever is a rare clinical problem, although its actual incidence is unknown because it is probably underdiagnosed.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,2</span></a> The list of drugs involved is extensive, although beta-lactam antibiotics seem to stand out due to their frequency.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">3</span></a> We present a case of fever induced by hydroxyurea (HU) without any other accompanying clinical manifestations.</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is a 66-year-old male with no history of interest except hypertension, dyslipidaemia and depressive syndrome, under treatment with aspirin, simvastatin, clomipramine, olmesartan medoxomil, amlodipine and hydrochlorothiazide. Diagnosed with essential thrombocythemia 7 years before, carrier of the V617F mutation in the JAK2 gene, without treatment during 3 weeks before admission, when HU administration started with a dose of 1000<span class="elsevierStyleHsp" style=""></span>mg/day. Admitted due to a 10-day long condition of malaise, myalgia and fever without any focal clinical evidence. Examination revealed a temperature of 39<span class="elsevierStyleHsp" style=""></span>°C and a systolic murmur. No skin lesions were observed. The blood count was normal, without eosinophilia. Biochemical studies showed values of 69<span class="elsevierStyleHsp" style=""></span>U/L AST, 55<span class="elsevierStyleHsp" style=""></span> U/L ALT and 24.4<span class="elsevierStyleHsp" style=""></span>mg/dL C-reactive protein, with no other abnormalities. Blood culture, urine culture, <span class="elsevierStyleItalic">Legionella</span> and pneumococcus antigen detection in urine and cytomegalovirus, Epstein–Barr virus, HIV, syphilis, <span class="elsevierStyleItalic">Brucella</span>, <span class="elsevierStyleItalic">Mycoplasma</span>, <span class="elsevierStyleItalic">Coxiella burnetii</span> and <span class="elsevierStyleItalic">Chlamydia</span> serology were all negative. The chest radiograph was normal and abdominal ultrasonography showed a hyperechogenic liver relative to fatty infiltration and increased prostate size. HU was discontinued at admission, with fever remission in 36 <span class="elsevierStyleHsp" style=""></span>h. Its controlled administration was resumed two weeks later with a single dose of 500<span class="elsevierStyleHsp" style=""></span>mg, showing recurrence of fever after 8<span class="elsevierStyleHsp" style=""></span>h.</p><p id="par0015" class="elsevierStylePara elsevierViewall">It has been estimated that drug-induced fever accounts for 0.01–5% of adverse drug reactions in hospitalized patients.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1–3</span></a> It is defined as a febrile reaction related to drug administration, which disappears as soon as the drug is interrupted and in the absence of other causes that may explain it.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">3,4</span></a> The most common mechanism for fever is a hypersensitivity reaction<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a>; although in these cases the fever is usually accompanied by skin lesions, eosinophilia or other manifestations, in the context of a delayed hypersensitivity syndrome or <span class="elsevierStyleItalic">Drug Reaction with Eosinophilia and Systemic Symptoms</span> (DRESS) syndrome.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> In the definition of drug-induced fever, patients in whom the fever is accompanied by skin lesions are specifically excluded.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">2,3</span></a> In the case of antineoplastic agents, the pharmacological action itself, which leads to cell necrosis and release of potential pyrogens, could contribute to the onset of fever.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> Early recognition of drug-induced fever is vital to avoid prolonged hospitalizations, unnecessary diagnostic procedures or treatments as well as new exposures to the inducing drug. Our case meets the criteria of causality established in the algorithm Karch and Lasagna,<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a> which classifies the adverse effect as clearly defined; however, compliance with these criteria requires rechallenge, which is not without risk and should not be done in severe cases.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The HU or hydroxyurea is an anticancer drug whose mechanism of action is the blocking of DNA synthesis mediated by the inhibition of the ribonucleotide reductase enzyme. It is used in the treatment of myeloproliferative diseases with negative Philadelphia chromosome and sickle cell anaemia. It is usually well tolerated; the most common side effects are myelosuppression with occurrence of peripheral cytopenias, digestive intolerance and skin lesions associated with its use, among which hyperpigmentation, alopecia and painful skin and mucous ulcers stand out. Pulmonary complications such as pneumonitis or bronchiolitis and drug-induced fever are less frequent.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> In a large series of 3411 patients treated with HU, drug-induced fever was observed in 0.5%.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a> 38 cases have been reported in the literature, including those reported in the series just mentioned and reviewed by Doutrelon et al.,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> no cases have been published in Spanish literature [Spanish Medical Index; search strategy of “hidroxiurea” (hydroxyurea) or “hidroxicarbamida” (hydroxycarbamide) and “fiebre” (fever)]. Fever appeared after an average of 21 days of treatment, was high (median 40<span class="elsevierStyleHsp" style=""></span>°C), well tolerated and rapidly disappeared after discontinuation of treatment. Re-exposure to HU occurred in 50% of cases, which was positive in all cases except one.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In short, we present a case of drug-induced fever associated to HU with characteristics consistent with those previously reported, being the first case study on Spanish literature.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Lizarralde Palacios E, Gutiérrez Macías A, Rámiz Martínez M, Escalante Boleas M. Fiebre por hidroxiurea. Med Clin (Barc). 2015;145:505–506.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Drug fever" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.A. Patel" 1 => "J.C. Gallagher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1592/phco.30.1.57" "Revista" => array:6 [ "tituloSerie" => "Pharmacotherapy" "fecha" => "2010" "volumen" => "30" "paginaInicial" => "57" "paginaFinal" => "69" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20030474" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0055" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Drug fever" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.H. Johnson" 1 => "B.A. Cunha" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Infect Dis Clin North Am" "fecha" => "1996" "volumen" => "10" "paginaInicial" => "85" "paginaFinal" => "91" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8698996" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0060" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Drug fever: a descriptive cohort study from the French national pharmacovigilance database" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Vodovar" 1 => "C. LeBeller" 2 => "B. Mégarbane" 3 => "A. Lillo-Le-Louet" 4 => "T. Hanslik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2165/11630640-000000000-00000" "Revista" => array:6 [ "tituloSerie" => "Drug Saf" "fecha" => "2012" "volumen" => "35" "paginaInicial" => "759" "paginaFinal" => "767" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22830618" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0065" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fièvre médicamenteuse: Un diagnostic à ne pas oublier" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Vodovar" 1 => "C. Le Beller" 2 => "A. Lillo-Le-Louet" 3 => "T. Hanslik" 4 => "B. Megarbane" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.revmed.2013.02.023" "Revista" => array:6 [ "tituloSerie" => "Rev Med Interne" "fecha" => "2014" "volumen" => "35" "paginaInicial" => "183" "paginaFinal" => "188" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23490338" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0070" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The DRESS syndrome: a literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Cacoub" 1 => "P. Musette" 2 => "V. Descamps" 3 => "O. Meyer" 4 => "C. Speirs" 5 => "L. Finzi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjmed.2011.01.017" "Revista" => array:6 [ "tituloSerie" => "Am J Med" "fecha" => "2011" "volumen" => "124" "paginaInicial" => "588" "paginaFinal" => "597" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21592453" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0075" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Toward the operational identification of adverse drug reactions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F.E. Karch" 1 => "L. Lasagna" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Pharmacol Ther" "fecha" => "1977" "volumen" => "21" "paginaInicial" => "247" "paginaFinal" => "254" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/837643" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0080" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hydroxycarbamide: a user's guide for chronic myeloproliferative disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.L. Spivak" 1 => "H. Hasselbalch" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1586/era.11.10" "Revista" => array:6 [ "tituloSerie" => "Expert Rev Anticancer Ther" "fecha" => "2011" "volumen" => "11" "paginaInicial" => "403" "paginaFinal" => "414" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21417854" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0085" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hydroxyurea-related toxicity in 3,411 patients with Ph’-negative MPN" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Antonioli" 1 => "P. Guglielmelli" 2 => "L. Pieri" 3 => "M. Finazzi" 4 => "E. Rumi" 5 => "V. Martinelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ajh.23160" "Revista" => array:7 [ "tituloSerie" => "Am J Hematol" "fecha" => "2012" "volumen" => "87" "paginaInicial" => "552" "paginaFinal" => "554" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22473827" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673610604849" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0090" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hyperthermie induite par l’hydroxyurée: à propos de 4 cas et revue de la littérature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Doutrelon" 1 => "E. Lazaro" 2 => "E. Ribeiro" 3 => "C. Greib" 4 => "J.L. Pellegrin" 5 => "J.F. Viallard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.revmed.2013.12.008" "Revista" => array:6 [ "tituloSerie" => "Rev Med Interne" "fecha" => "2015" "volumen" => "36" "paginaInicial" => "73" "paginaFinal" => "77" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24406312" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014500000011/v1_201604300039/S2387020616300365/v1_201604300039/en/main.assets" "Apartado" => array:4 [ "identificador" => "43311" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014500000011/v1_201604300039/S2387020616300365/v1_201604300039/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616300365?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 1 | 0 | 1 |
