Gemcitabine
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Haemolytic uraemic syndrome in an elderly patient: case report A 68-year-old man developed haemolytic uraemic syndrome (HUS) during chemotherapy with gemcitabine [Gemzar; route not stated] for metastatic pancreatic cancer. The man, whose history included controlled arterial hypertension and Graves’ disease, started receiving gemcitabine 1000 mg/m2 weekly induction therapy in December 2006, followed by 15 maintenance cycles comprising gemcitabine 1000 mg/m2 on days 1–8 and 15, followed by 1 week of rest. Hypertension of 170/100mm Hg emerged on day 15 of the 15th cycle, and he became anaemic. His acebutolol dosage was increased, and erythropoietin was added to his treatment. Tumour progression was evident before the 16th cycle and, in March 2008, he was admitted for second-line therapy in association with capecitabine and oxaliplatin. Before treatment initiation, hypertension persisted (160/100mm Hg), and laboratory investigations revealed the following: haemoglobin 6.5 g/dL, MCV 107fL, creatinine 166 µmol/L, creatinine clearance 47 mL/mm, urea 9.7 mmol/L, haptoglobin ≤ 0.07 g/L, LDH 1600 IU/L and 3% schistocytes on blood smear; he also had proteinuria and haematuria. The man received RBCs and a loop diuretic, and his haemoglobin level and BP normalised. Due to gastrointestinal intolerance, capecitabine was switched to fluorouracil without HUS recurrence. Assi C, et al. Chronic anemia resistant to erythropoietin in a patient treated with gemcitabine showing a hemolytic uremic syndrome (HUS). Gastroenterologie Clinique et Biologique 34: e640-642, No. 11, Nov 2010. Available from: URL: 803048123 http://dx.doi.org/10.1016/j.gcb.2010.07.020 - France
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Reactions 15 Jan 2011 No. 1334
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