Gemcitabine-induced Hemolytic Uremic Syndrome Mimicking Scleroderma Renal Crisis Presenting with Raynaud's Phenomenon, Positive Antinuclear Antibodies and Hypertensive Emergency

被引：8

作者：

Yamada, Yuichiro ^{[1
]}

Suzuki, Keisuke ^{[1
]}

Nobata, Hironobu ^{[1
]}

Kawai, Hirohisa ^{[1
]}

Wakamatsu, Ryo ^{[1
]}

Miura, Naoto ^{[1
]}

Banno, Shogo ^{[1
]}

Imai, Hirokazu ^{[1
]}

机构：

[1] Aichi Med Univ, Sch Med, Dept Internal Med, Div Nephrol & Rheumatol, Aichi, Japan

来源：

INTERNAL MEDICINE | 2014年 / 53卷 / 05期

关键词：

gemcitabine; antinuclear antibody; Raynaud's phenomenon; hemolytic uremic syndrome; hypertensive emergency; fresh frozen plasma; THROMBOTIC MICROANGIOPATHY; SYSTEMIC-SCLEROSIS; CANCER; THERAPY; CARCINOMA;

D O I：

10.2169/internalmedicine.53.1160

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 58-year-old woman who received gemcitabine for advanced gallbladder cancer developed an impaired renal function, thrombocytopenia, Raynaud's phenomenon, digital ischemic changes, a high antinuclear antibody titer and hypertensive emergency that mimicked a scleroderma renal crisis. A kidney biopsy specimen demonstrated onion-skin lesions in the arterioles and small arteries along with ischemic changes in the glomeruli, compatible with a diagnosis of hypertensive emergency (malignant hypertension). The intravenous administration of a calcium channel blocker, the oral administration of an angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker and the transfusion of fresh frozen plasma were effective for treating the thrombocytopenia and progressive kidney dysfunction. Gemcitabine induces hemolytic uremic syndrome with accelerated hypertension and Raynaud's phenomenon, mimicking scleroderma renal crisis.

引用

页码：445 / 448

页数：4