Gemcitabine-induced thrombotic microangiopathy with nephrotic syndrome

被引：8
作者：
Katagiri D. [1 ]
Hinoshita F. [2 ]
机构：
[1] Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN
[2] Department of Nephrology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, 162-8655, Tokyo
来源：
CEN Case Reports | 2018年 / 7卷 / 2期
关键词：
AKI; Gemcitabine; Nephrotic syndrome; Thrombotic microangiopathy;
D O I：
10.1007/s13730-018-0332-3
中图分类号：
学科分类号：
摘要：
We encountered a case of gemcitabine (GEM)-induced secondary thrombotic microangiopathy (TMA) with nephrotic syndrome. Advanced pancreatic cancer with liver metastasis had originally been diagnosed. Renal biopsy showed focal reduplication of the glomerular basement membrane, endothelial cell swelling, and narrowed capillary lumens with fragmented erythrocytes and fibrin deposition, compatible with TMA. Regular monitoring of renal function during GEM treatment and discontinuation of treatment if acute kidney injury (AKI) might occur is crucial, because AKI combined with TMA is life-threatening.
引用
收藏
页码：217 / 220
页数：3
相关论文
共 36 条
  • [1] Humphreys BD(2004)Gemcitabine-associated thrombotic microangiopathy Cancer 100 2664-2670
  • [2] Sharman JP(2014)Gemcitabine-induced hemolytic uremic syndrome in pancreatic cancer: a case report and review of the literature Gut Liver 8 109-112
  • [3] Henderson JM(2014)Gemcitabine-induced hemolytic uremic syndrome mimicking scleroderma renal crisis presenting with Raynaud’s phenomenon, positive antinuclear antibodies and hypertensive emergency Intern Med 53 445-448
  • [4] Lee HW(2014)How I treat thrombotic thrombocytopenic purpura and atypical haemolytic uraemic syndrome Br J Haematol 164 759-766
  • [5] Chung MJ(2017)HUS and atypical HUS Blood 129 2847-2856
  • [6] Kang H(2013)Role of ADAMTS13 in the management of thrombotic microangiopathies including thrombotic thrombocytopenic purpura (TTP) Br J Haematol 163 514-519
  • [7] Yamada Y(2016)Clinical guides for atypical hemolytic uremic syndrome in Japan Clin Exp Nephrol 20 536-543
  • [8] Suzuki K(2012)Cancer-related microangiopathic hemolytic anemia: clinical and laboratory features in 168 reported cases Medicine (Baltimore) 91 195-205
  • [9] Nobata H(2011)Thrombotic microangiopathy with targeted cancer agents Clin Cancer Res 17 5858-5866
  • [10] Scully M(1996)Gemcitabine safety overview Semin Oncol 23 32-35
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