{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T15:56:02Z","timestamp":1776095762015,"version":"3.50.1"},"reference-count":32,"publisher":"Federacion Colombiana de Obstetricia y Ginecologia","issue":"4","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["revista.fecolsog.org"],"crossmark-restriction":false},"short-container-title":["Rev. colomb. obstet. ginecol."],"abstract":"<jats:p>Objetivos: presentar el caso de una paciente con carcinoma escamocelular de cuello uterino que desarroll\u00f3 necrosis distal tras tratamiento con gemcitabina, y realizar una revisi\u00f3n de la literatura para evaluar la asociaci\u00f3n entre la dosis acumulada de gemcitabina, el diagn\u00f3stico y el manejo de esta complicaci\u00f3n.\nMateriales y m\u00e9todos: paciente de 61 a\u00f1os tratada con gemcitabina (11.744 mg\/m\u00b2 acumulados) por enfermedad metast\u00e1sica, en un hospital general de cuarto nivel, privado, no oncol\u00f3gico, donde ven\u00eda siendo manejada de forma ambulatoria. Present\u00f3 necrosis distal del segundo dedo de la mano derecha, por lo que se suspendi\u00f3 el tratamiento y se requiri\u00f3 amputaci\u00f3n de este dedo. Se realiz\u00f3 una b\u00fasqueda en Embase, Medline y Lilacs. Se buscaron estudios de reporte y series de casos sobre necrosis distal inducida por gemcitabina. Se extrajeron datos de dosis, diagn\u00f3stico y tratamiento.\nResultados: se incluyeron 15 reportes de caso con 19 casos de necrosis distal. Las dosis acumuladas de gemcitabina variaron entre 1.700 y 28.700 mg \/m\u00b2. El diagn\u00f3stico fue principalmente cl\u00ednico, por angiograf\u00eda y eco-Doppler; el tratamiento incluy\u00f3 la suspensi\u00f3n de gemcitabina e inicio de vasodilatadores, anticoagulantes y manejo sintom\u00e1tico.\nConclusiones: es fundamental reconocer la toxicidad vascular como un posible efecto adverso de la gemcitabina y realizar una adecuada estratificaci\u00f3n del riesgo en pacientes con c\u00e1ncer avanzado y m\u00faltiples l\u00edneas de tratamiento previas. Se requiere incrementar la vigilancia de este efecto adverso con el uso de este medicamento.<\/jats:p>","DOI":"10.18597\/rcog.4248","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T09:00:46Z","timestamp":1732698046000},"update-policy":"https:\/\/doi.org\/10.18597\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Necrosis digital inducida por gemcitabina en una paciente con carcinoma escamocelular de cuello uterino: reporte de un caso y revisi\u00f3n de la literatura","Gemcitabine-induced digital necrosis in a patient with cervical squamous cell carcinoma: case report and literature review"],"prefix":"10.18597","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8617-1382","authenticated-orcid":false,"given":"Syndy","family":"Guar\u00edn-Rivera","sequence":"first","affiliation":[{"name":"Internal Medicine Service, Hospital Universitario Mayor M\u00e9deri. Bogot\u00e1 (Colombia); Clinical Epidemiology, Fundaci\u00f3n Universitaria de Ciencias de la Salud. Bogot\u00e1 (Colombia)."},{"name":"Servicio de Medicina interna, Hospital Universitario Mayor M\u00e9deri. Bogot\u00e1 (Colombia); Epidemiolog\u00eda Cl\u00ednica, Fundaci\u00f3n Universitaria de Ciencias de la Salud. Bogot\u00e1 (Colombia)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7996-5246","authenticated-orcid":false,"given":"Harold","family":"Pineda-Arango","sequence":"additional","affiliation":[{"name":"Internal Medicine Service, Hospital Universitario Mayor M\u00e9deri. Bogot\u00e1 (Colombia)."},{"name":"Servicio de Medicina interna, Hospital Universitario Mayor M\u00e9deri. Bogot\u00e1 (Colombia)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3434-0479","authenticated-orcid":false,"given":"C\u00e9sar","family":"Balaguera-Becerra","sequence":"additional","affiliation":[{"name":"Internal Medicine Service, Hospital Universitario Mayor M\u00e9deri. Bogot\u00e1 (Colombia)."},{"name":"Servicio de Medicina interna, Hospital Universitario Mayor M\u00e9deri. Bogot\u00e1 (Colombia)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7821-0508","authenticated-orcid":false,"given":"Marisol","family":"Carre\u00f1o-Jaimes","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology, Hospital Militar Central. Bogot\u00e1 (Colombia)."},{"name":"Epidemiolog\u00eda Cl\u00ednica, Hospital Militar Central. Bogot\u00e1 (Colombia)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7407-6900","authenticated-orcid":false,"given":"Jes\u00fas","family":"Utria-Munive","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology, Fundaci\u00f3n Universitaria de Ciencias de la Salud. Bogot\u00e1 (Colombia)."},{"name":"Epidemiolog\u00eda Cl\u00ednica, Fundaci\u00f3n Universitaria de Ciencias de la Salud. Bogot\u00e1 (Colombia)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"7913","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"key":"101685","unstructured":"BC Cancer. Gemcitabine [Internet]. 2021. Disponible en: http:\/\/www.bccancer.bc.ca\/drug-database-site\/Drug %20Index\/Gemcitabine_monograph.pdf"},{"key":"101686","doi-asserted-by":"crossref","unstructured":"Mini E, Nobili S, Caciagli B, Landini I, Mazzei T. Cellular pharmacology of gemcitabine. 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