Chen Chien-Han, Lu Meng-Yao, Lin Kai-Hsin, Lin Dong-Tsamn, Peng Shinn-Forng, Jou Shiann-Tarng
Department of Pediatrics, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
J Formos Med Assoc. 2004 May;103(5):380-4.
L-asparaginase, an effective antileukemia and antilymphoma agent, is toxic to many organ systems. We report a case of ureteral obstruction caused by L-asparaginase via the inflammatory complication of acute pancreatitis. The patient was an 11-year-old boy with acute lymphoblastic leukemia. Six days after completing a 4-week induction therapy containing 9 doses of L-asparaginase, severe left abdominal pain developed. Abdominal computed tomography showed phlegmon formation anterior to the pancreatic head and in the left posterior pararenal space. The strands of inflammatory soft tissues encased the upper third of the left ureter, causing left hydroureter and left hydronephrosis. The ureteral obstruction resolved after insertion of a double-J catheter that remained in place for 66 days. This case suggests that L-asparaginase may play a role in the pathogenesis of ureteral obstruction in children receiving chemotherapy.
L-天冬酰胺酶是一种有效的抗白血病和抗淋巴瘤药物，但对许多器官系统有毒性。我们报告一例由L-天冬酰胺酶通过急性胰腺炎的炎症并发症导致输尿管梗阻的病例。患者为一名11岁患有急性淋巴细胞白血病的男孩。在完成包含9剂L-天冬酰胺酶的4周诱导治疗6天后，出现严重的左腹痛。腹部计算机断层扫描显示胰头前方和左肾后间隙有蜂窝织炎形成。炎性软组织条索包裹了左输尿管上三分之一，导致左输尿管积水和左肾积水。插入双J导管并留置66天后，输尿管梗阻得以缓解。该病例提示L-天冬酰胺酶可能在接受化疗的儿童输尿管梗阻的发病机制中起作用。
