Ogura Takeshi, Tajika Masahiro, Niwa Yasumasa, Kawai Hiroki, Kondo Shinya, Sawaki Akira, Mizuno Nobumasa, Hara Kazuo, Hijioka Susumu, Nakamura Masamichi, Higuchi Kazuhide, Goto Hidemi, Yamao Kenji
Department of Gastroenterology, Aichi Cancer Center Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2011 Oct;108(10):1712-9.
We describe a 54-year old woman with oxaliplatin-induced autoimmune hemolytic anemia and review the clinical features of similar published cases. The present patient had metastatic colon cancer and was admitted to our hospital with a floating sensation and general malaise on day 4 after undergoing the last of 4 cycles of a 7th round of chemotherapy with XELOX. Laboratory data revealed 4.6g/dl hemoglobin and 8.77 mg/dl creatinine. Direct and indirect Coombs tests of a blood sample for blood transfusion were both positive. We diagnosed immune hemolysis with acute renal failure based on the clinical course and blood samples showing haptoglobin <10mg/dl. We treated her with hemodialysis, plasmapheresis and immune suppression with prednisolone, which improved the anemia and renal failure.
我们描述了一名54岁患有奥沙利铂诱导的自身免疫性溶血性贫血的女性,并回顾了已发表的类似病例的临床特征。该患者患有转移性结肠癌,在接受第7轮化疗的XELOX方案4个周期中的最后一个周期化疗后第4天,因有漂浮感和全身不适入院。实验室检查数据显示血红蛋白为4.6g/dl,肌酐为8.77mg/dl。用于输血的血样直接和间接抗人球蛋白试验均为阳性。根据临床病程以及血样显示触珠蛋白<10mg/dl,我们诊断为免疫性溶血伴急性肾衰竭。我们对她进行了血液透析、血浆置换以及用泼尼松龙进行免疫抑制治疗,这些治疗改善了贫血和肾衰竭。