Nishiyama Y, Komaba Y, Kitamura H, Katayama Y
Second Department of Internal Medicine, Nippon Medical School, Tokyo.
Intern Med. 2001 Mar;40(3):237-40. doi: 10.2169/internalmedicine.40.237.
A 50-year-old woman treated for breast cancer with mitomycin C developed severe hypertension, followed by deep coma 3 days later. Computed tomography of the brain showed frontoparietal intracranial hemorrhage accompanied by subarachnoid hemorrhage. The patient was diagnosed additionally with hemolytic uremic syndrome (HUS) based on hemolytic anemia with schistocytosis, thrombocytopenia, and acute renal failure. The patient underwent hemodialysis and plasmapheresis with no improvement. We present the pathologic findings of the general vessels, which has been reported rarely. This case represents the first reported intracranial hemorrhage in HUS following mitomycin C administration. We emphasize the need to control blood pressure in patients with HUS.
一名50岁女性因乳腺癌接受丝裂霉素C治疗，出现严重高血压，3天后陷入深度昏迷。脑部计算机断层扫描显示额顶叶颅内出血并伴有蛛网膜下腔出血。根据伴有裂体细胞症的溶血性贫血、血小板减少症和急性肾衰竭，该患者还被诊断为溶血性尿毒症综合征（HUS）。患者接受血液透析和血浆置换治疗，但病情无改善。我们展示了一般血管的病理结果，此前鲜有报道。该病例是首例报道的丝裂霉素C给药后HUS并发颅内出血。我们强调对HUS患者控制血压的必要性。
