Thrombotic microangiopathy and digital necrosis: two unrecognized toxicities of gemcitabine
| Autor: | D. Genet, K Ly, J L Labourey, Laurence Venat-Bouvet, J. Martin, Nicole Tubiana-Mathieu, J C Szelag |
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| Rok vydání: | 2003 |
| Předmět: |
Hemolytic anemia
Adult Male Cancer Research medicine.medical_specialty Antimetabolites Antineoplastic Thrombotic microangiopathy medicine.medical_treatment Vasodilator Agents Adenocarcinoma Gastroenterology Deoxycytidine Fingers Gangrene Internal medicine Necrotizing Vasculitis medicine Carcinoma Humans Pharmacology (medical) Iloprost Pharmacology Chemotherapy Carcinoma Transitional Cell Vascular disease Cumulative dose business.industry Middle Aged medicine.disease Gemcitabine Surgery Pancreatic Neoplasms Oncology Urinary Bladder Neoplasms Hemolytic-Uremic Syndrome business medicine.drug |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 0959-4973 |
| Popis: | We report one new case of hemolytic-uremic syndrome (HUS) and one case of digital necrosis after treatment with gemcitabine (Gemzar). Case 1, a 34-year-old man, was given first-line metastatic treatment with gemcitabine for a adenocarcinoma of the pancreas. After a cumulative dose of 10 000 mg/m2 gemcitabine, the onset of subacute renal failure associated with hemolytic anemia of mechanical origin was observed. A diagnosis of probable gemcitabine-induced thrombotic microangiopathy was arrived at. Symptoms resolved after stopping the chemotherapy, in spite of the progression of the disease. Case 2, a 61-year-old man, was administered a combination of gemcitabine and a platinum salt as first-line metastatic treatment for carcinoma of the bladder urothelium. Following a cumulative dose of 10 000 mg/m2 of gemcitabine, the patient suffered from bilateral peripheral vascular disease of somewhat acute onset with hemorrhagic lesions of the finger pads that became necrotic. The work-up was negative and a causal relationship was attributed to gemcitabine. The patient made good progress when given an i.v. infusion of Ilomedine (iloprost trometamol) and chemotherapy was withdrawn. We conclude that gemcitabine must be added to the list of drugs that cause HUS and necrotizing vasculitis. |
| Databáze: | OpenAIRE |
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