Khansur T, Kennedy A
Department of Veterans Affairs, Medical Center, Jackson, MS 39216.
Am J Med Sci. 1991 Jun;301(6):390-2. doi: 10.1097/00000441-199106000-00006.
Two patients developed noncardiogenic pulmonary edema (NCPE), following red blood cell transfusion in a setting of acute cisplatin nephropathy. One manifested the full picture of hemolytic uremic syndrome, the other had transient features following blood transfusion. We further reviewed the clinical records on blood transfusion for all patients with cisplatin nephropathy. A third case of (NCPE) was identified in a patient with acute renal dysfunction. However, none of the 16 patients with cisplatin-induced, mild stable chronic renal impairment had pulmonary dysfunction or other laboratory evidence for microangiopathy following transfusion. Hemolytic uremic syndrome may be a rare manifestation of cisplatin toxicity. Caution is indicated in transfusing patients with acute platinum nephropathy even in the absence of overt microangiopathy. The pathogenesis of this syndrome and the cause for NCPE is unclear. The literature is reviewed and discussed.
两名急性顺铂肾病患者在输注红细胞后发生了非心源性肺水肿（NCPE）。其中一名表现出溶血尿毒综合征的全貌，另一名在输血后有短暂症状。我们进一步查阅了所有顺铂肾病患者的输血临床记录。在一名急性肾功能不全患者中发现了第三例（NCPE）。然而，16例顺铂诱导的轻度稳定慢性肾功能损害患者在输血后均无肺功能障碍或其他微血管病的实验室证据。溶血尿毒综合征可能是顺铂毒性的一种罕见表现。即使在没有明显微血管病的情况下，给急性铂肾病患者输血时也应谨慎。该综合征的发病机制及NCPE的病因尚不清楚。本文对相关文献进行了综述和讨论。
