Ohashi Shinya, Yazumi Shujiro, Nishio Akiyoshi, Fukui Toshiro, Asada Masanori, Chiba Tsutomu
Department of Gastroenterology and Hepatology, Tazuke-Kofukai Medical Research Institute and Kitano Hospital, 2-4-20 Ogimachi, Kita-ku, Osaka 530-8480, Japan.
Intern Med. 2006;45(18):1049-53. doi: 10.2169/internalmedicine.45.1720. Epub 2006 Oct 16.
We report a 29-year-old woman with gastric cancer who developed Trousseau's syndrome, a malignancy-related thromboembolism, during chemotherapy. She was diagnosed with a mucin-producing adenocarcinoma of the stomach, and chemotherapy with S-1 and cisplatin was commenced. During treatment, she developed a sudden onset of right hemiplegia. Magnetic resonance imaging showed an acute cerebral infarction of the left cerebral hemisphere. The underlying pathophysiology is thought to be chronic disseminated intravascular coagulation due to mucin-producing adenocarcinomas. However, cisplatin-induced vascular toxicity and hypercoagulability caused by decreased plasma protein C activity, elevated plasma von-Willebrand factor levels, and hypomagnesemia has also been proposed to be associated with thrombogenicity.
我们报告了一名29岁的胃癌女性患者，她在化疗期间出现了Trousseau综合征，这是一种与恶性肿瘤相关的血栓栓塞症。她被诊断为胃黏液腺癌，并开始接受S-1和顺铂化疗。治疗期间，她突然出现右侧偏瘫。磁共振成像显示左脑半球急性脑梗死。其潜在的病理生理学被认为是由于黏液腺癌导致的慢性弥散性血管内凝血。然而，也有人提出顺铂诱导的血管毒性以及血浆蛋白C活性降低、血浆血管性血友病因子水平升高和低镁血症引起的高凝状态与血栓形成有关。
