Nephrotic Syndrome and Posterior Reversible Encephalopathy Syndrome as Clinical Presentations of Gemcitabine-Induced Thrombotic Micro-Angiopathy

被引:1
作者
Jha, Vijoy Kumar [1 ,5 ]
Akal, Ramanjit Singh [1 ]
Mahapatra, Debasish [1 ]
Sharma, Alok [2 ]
Singh, Bhanu Pratap [3 ]
Arora, Rahil [4 ]
机构
[1] Command Hosp Air Force, Dept Nephrol, Bengaluru, Karnataka, India
[2] Lal PathLabs Ltd, Renal Pathol & Electron Microscopy, New Delhi, India
[3] Command Hosp Air Force, Dept Radiol, Bengaluru, Karnataka, India
[4] Command Hosp Air Force, Dept Med, Bengaluru, Karnataka, India
[5] Command Hosp Air Force, Bangalore 560007, Karnataka, India
关键词
Gemcitabine; nephrotic syndrome; PRES; TMA; HEMOLYTIC-UREMIC SYNDROME; MICROANGIOPATHY; CHEMOTHERAPY; CANCER;
D O I
10.4103/ijn.ijn_277_22
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Gemcitabine-induced thrombotic micro-angiopathy (GiTMA) is a very rare pathology of micro-vascular occlusion with a poor prognosis. In this case report, we present a young male with pancreatic carcinoma who received gemcitabine as adjuvant chemotherapy and developed thrombotic micro-angiopathy (TMA) manifesting as nephrotic syndrome with renal dysfunction and posterior reversible encephalopathy syndrome (PRES). The case was successfully managed with discontinuation of the drug and conservative management. The pathogenesis of GiTMA might be direct endothelial dysfunction with consequent activation of the clotting system. The role of plasma exchanges and monoclonal antibodies is unclear in drug-induced TMA.
引用
收藏
页码:74 / 78
页数:5
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