三例卵巢癌患者在接受吉西他滨与聚乙二醇化脂质体阿霉素联合治疗后发生溶血尿毒综合征。
Three cases of hemolytic uremic syndrome in ovarian cancer patients treated with combination gemcitabine and pegylated liposomal doxorubicin.
作者信息
Lewin Sharyn N, Mutch David G, Whitcomb Bradford P, Liapis Helen, Herzog Thomas J
机构信息
Division of Gynecologic Oncology, Washington University School of Medicine, 4911 Barnes Jewish Hospital Plaza, Box 8064, St. Louis, MO 63110-1094, USA.
出版信息
Gynecol Oncol. 2005 Apr;97(1):228-33. doi: 10.1016/j.ygyno.2004.12.027.
BACKGROUND
Hemolytic uremic syndrome (HUS) is a rare coagulation disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute uremia. Reports have described this fatal syndrome in association with cytotoxic agents. To our knowledge, no case reports of HUS in ovarian cancer patients receiving treatment with combination gemcitabine and pegylated liposomal doxorubicin (PLD) have been reported.
CASE REPORTS
Three patients with recurrent ovarian carcinoma each developed profound hypertension and peripheral edema while receiving combination gemcitabine and PLD. The first patient had rapid hemolysis, thrombocytopenia, renal failure and respiratory distress. The other patients experienced slowly progressive renal failure and mild hematologic abnormalities. Two of the three patients had favorable outcomes.
CONCLUSION
The reported incidence of gemcitabine-induced HUS is rare. Clinicians should suspect HUS if blood pressure elevation or peripheral edema develop.
背景
溶血性尿毒症综合征（HUS）是一种罕见的凝血障碍，其特征为微血管病性溶血性贫血、血小板减少和急性尿毒症。已有报道称这种致命综合征与细胞毒性药物有关。据我们所知，尚未有关于接受吉西他滨联合聚乙二醇化脂质体阿霉素（PLD）治疗的卵巢癌患者发生HUS的病例报告。
病例报告
三名复发性卵巢癌患者在接受吉西他滨联合PLD治疗时均出现严重高血压和外周水肿。第一名患者出现快速溶血、血小板减少、肾衰竭和呼吸窘迫。其他患者经历了缓慢进展的肾衰竭和轻度血液学异常。三名患者中有两名预后良好。
结论
吉西他滨诱导的HUS报告发病率罕见。如果出现血压升高或外周水肿，临床医生应怀疑HUS。
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