吉西他滨诱导的血栓性微血管病伴肾病综合征。
Gemcitabine-induced thrombotic microangiopathy with nephrotic syndrome.
作者信息
Katagiri Daisuke, Hinoshita Fumihiko
机构信息
Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Nephrology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, 162-8655, Tokyo, Japan.
出版信息
CEN Case Rep. 2018 Nov;7(2):217-220. doi: 10.1007/s13730-018-0332-3. Epub 2018 May 15.
Abstract
We encountered a case of gemcitabine (GEM)-induced secondary thrombotic microangiopathy (TMA) with nephrotic syndrome. Advanced pancreatic cancer with liver metastasis had originally been diagnosed. Renal biopsy showed focal reduplication of the glomerular basement membrane, endothelial cell swelling, and narrowed capillary lumens with fragmented erythrocytes and fibrin deposition, compatible with TMA. Regular monitoring of renal function during GEM treatment and discontinuation of treatment if acute kidney injury (AKI) might occur is crucial, because AKI combined with TMA is life-threatening.
摘要
我们遇到了一例吉西他滨（GEM）诱发的继发性血栓性微血管病（TMA）合并肾病综合征的病例。最初诊断为晚期胰腺癌伴肝转移。肾活检显示肾小球基底膜局灶性重复、内皮细胞肿胀、毛细血管腔狭窄，伴有破碎红细胞和纤维蛋白沉积，符合TMA表现。在GEM治疗期间定期监测肾功能，若可能发生急性肾损伤（AKI）则停止治疗至关重要，因为AKI合并TMA会危及生命。
相似文献
1
Gemcitabine-induced thrombotic microangiopathy with nephrotic syndrome.吉西他滨诱导的血栓性微血管病伴肾病综合征。
CEN Case Rep. 2018 Nov;7(2):217-220. doi: 10.1007/s13730-018-0332-3. Epub 2018 May 15.
2
Reversible renal-limited thrombotic microangiopathy due to gemcitabine-dexamethasone-cisplatin therapy: a case report.吉西他滨-地塞米松-顺铂治疗致可逆性肾性血栓性微血管病：病例报告。
BMC Nephrol. 2021 May 12;22(1):175. doi: 10.1186/s12882-021-02386-y.
3
The Detection of Urinary Podocytes from Drug-Induced Glomerular Thrombotic Microangiopathy in Advanced Cancer Patients.晚期癌症患者药物性肾小球血栓性微血管病中尿足细胞的检测
Clin Lab. 2016 Dec 1;62(12):2413-2417. doi: 10.7754/Clin.Lab.2016.160525.
4
Decitabine-induced kidney thrombotic microangiopathy with glomerular crescents formation and tubular necrosis: A case report.地西他滨诱发的伴有肾小球新月体形成和肾小管坏死的肾血栓性微血管病：一例报告
Medicine (Baltimore). 2020 Oct 23;99(43):e22901. doi: 10.1097/MD.0000000000022901.
5
Gemcitabine-induced thrombotic microangiopathy.吉西他滨诱导的血栓性微血管病。
Intern Med J. 2013 Nov;43(11):1240-2. doi: 10.1111/imj.12261.
6
The use of eculizumab in gemcitabine induced thrombotic microangiopathy.依库珠单抗在吉西他滨诱导的血栓性微血管病中的应用。
BMC Nephrol. 2018 Jan 12;19(1):9. doi: 10.1186/s12882-018-0812-x.
7
Gemcitabine-related thrombotic microangiopathy: a single-centre retrospective series.吉西他滨相关血栓性微血管病：一项单中心回顾性研究系列
J Chemother. 2014 Jun;26(3):169-72. doi: 10.1179/1973947813Y.0000000122. Epub 2013 Dec 6.
8
Eculizumab in gemcitabine-induced thrombotic microangiopathy: experience of the French thrombotic microangiopathies reference centre.依库珠单抗治疗吉西他滨诱导的血栓性微血管病：法国血栓性微血管病参考中心的经验。
BMC Nephrol. 2021 Jul 21;22(1):267. doi: 10.1186/s12882-021-02470-3.
9
Gemcitabine-associated livedoid thrombotic microangiopathy with associated sclerema neonatorum-like microscopic changes.
J Cutan Pathol. 2012 Jul;39(7):707-11. doi: 10.1111/j.1600-0560.2012.01918.x. Epub 2012 May 22.
10
Thrombotic microangiopathy associated with gemcitabine use: Presentation and outcome in a national French retrospective cohort.与吉西他滨使用相关的血栓性微血管病：法国全国回顾性队列研究中的表现和结局。
Br J Clin Pharmacol. 2019 Feb;85(2):403-412. doi: 10.1111/bcp.13808. Epub 2018 Dec 18.
引用本文的文献
1
Melatonin augments anti-tumor activity and alleviates nephrotoxicity of gemcitabine in a pancreatic cancer xenograft model targeting P62/Keap1 pathway.褪黑素增强吉西他滨在靶向P62/Keap1通路的胰腺癌异种移植模型中的抗肿瘤活性并减轻其肾毒性。
Naunyn Schmiedebergs Arch Pharmacol. 2025 Mar 18. doi: 10.1007/s00210-025-03938-x.
2
Nephrotic Syndrome and Posterior Reversible Encephalopathy Syndrome as Clinical Presentations of Gemcitabine-Induced Thrombotic Micro-Angiopathy.吉西他滨诱导的血栓性微血管病的临床表现为肾病综合征和后部可逆性脑病综合征
Indian J Nephrol. 2024 Jan-Feb;34(1):74-78. doi: 10.4103/ijn.ijn_277_22. Epub 2023 Mar 7.
3
Gemcitabine-Induced Renal Thrombotic Microangiopathy.吉西他滨诱导的肾血栓性微血管病。
Indian J Nephrol. 2023 Jul-Aug;33(4):319-320. doi: 10.4103/ijn.ijn_321_22. Epub 2023 Mar 8.
4
Time to Onset of Gemcitabine-induced Thrombotic Microangiopathy in a Japanese Population: A Case Series and Large-scale Pharmacovigilance Analysis.日本人群中吉西他滨诱导的血栓性微血管病的发病时间：病例系列和大规模药物警戒分析。
Cancer Diagn Progn. 2023 Jan 3;3(1):115-123. doi: 10.21873/cdp.10188. eCollection 2023 Jan-Feb.
5
Concomitant Nephrotic Syndrome and Cryoglobulinemia in a Case of Malignant Mesothelioma.恶性间皮瘤病例中伴发的肾病综合征和冷球蛋白血症
Case Rep Nephrol. 2022 Sep 28;2022:8677293. doi: 10.1155/2022/8677293. eCollection 2022.
6
A rare case report of gemcitabine-induced thrombotic microangiopathies.吉西他滨诱导的血栓性微血管病的罕见病例报告。
SAGE Open Med Case Rep. 2021 May 24;9:2050313X211013208. doi: 10.1177/2050313X211013208. eCollection 2021.
7
A Case of Gemcitabine-Induced Thrombotic Microangiopathy Treated With Ravulizumab in a Patient With Stage IV Pancreatic Cancer.1例IV期胰腺癌患者使用ravulizumab治疗吉西他滨诱导的血栓性微血管病
Cureus. 2021 Jan 31;13(1):e13031. doi: 10.7759/cureus.13031.
8
COVID-19-Associated Kidney Injury: A Case Series of Kidney Biopsy Findings.COVID-19 相关肾损伤：肾活检结果的病例系列。
J Am Soc Nephrol. 2020 Sep;31(9):1948-1958. doi: 10.1681/ASN.2020050699. Epub 2020 Jul 13.
本文引用的文献
1
Thrombotic Microangiopathy and the Kidney.血栓性微血管病与肾脏。
Clin J Am Soc Nephrol. 2018 Feb 7;13(2):300-317. doi: 10.2215/CJN.00620117. Epub 2017 Oct 17.
2
HUS and atypical HUS.溶血尿毒综合征和非典型溶血尿毒综合征。
Blood. 2017 May 25;129(21):2847-2856. doi: 10.1182/blood-2016-11-709865. Epub 2017 Apr 17.
3
The Detection of Urinary Podocytes from Drug-Induced Glomerular Thrombotic Microangiopathy in Advanced Cancer Patients.晚期癌症患者药物性肾小球血栓性微血管病中尿足细胞的检测
Clin Lab. 2016 Dec 1;62(12):2413-2417. doi: 10.7754/Clin.Lab.2016.160525.
4
Clinical guides for atypical hemolytic uremic syndrome in Japan.日本非典型溶血性尿毒症综合征临床指南。
Clin Exp Nephrol. 2016 Aug;20(4):536-543. doi: 10.1007/s10157-016-1276-6.
5
Interstitial renal fibrosis due to multiple cisplatin treatments is ameliorated by semicarbazide-sensitive amine oxidase inhibition.多次顺铂治疗引起的间质肾纤维化可通过抑制氨基脲敏感胺氧化酶得到改善。
Kidney Int. 2016 Feb;89(2):374-85. doi: 10.1038/ki.2015.327.
6
Gemcitabine-induced hemolytic uremic syndrome mimicking scleroderma renal crisis presenting with Raynaud's phenomenon, positive antinuclear antibodies and hypertensive emergency.吉西他滨诱导的溶血性尿毒症综合征，类似硬皮病肾危象，表现为雷诺现象、抗核抗体阳性及高血压急症。
Intern Med. 2014;53(5):445-8. doi: 10.2169/internalmedicine.53.1160.
7
Gemcitabine-induced hemolytic uremic syndrome in pancreatic cancer: a case report and review of the literature.吉西他滨诱导的胰腺癌溶血尿毒综合征：病例报告及文献复习。
Gut Liver. 2014 Jan;8(1):109-12. doi: 10.5009/gnl.2014.8.1.109. Epub 2014 Jan 13.
8
How I treat thrombotic thrombocytopenic purpura and atypical haemolytic uraemic syndrome.我如何治疗血栓性血小板减少性紫癜和非典型溶血尿毒综合征。
Br J Haematol. 2014 Mar;164(6):759-66. doi: 10.1111/bjh.12718. Epub 2014 Jan 6.
9
Role of ADAMTS13 in the management of thrombotic microangiopathies including thrombotic thrombocytopenic purpura (TTP).ADAMTS13 在血栓性微血管病（包括血栓性血小板减少性紫癜[TTP]）管理中的作用。
Br J Haematol. 2013 Nov;163(4):514-9. doi: 10.1111/bjh.12569. Epub 2013 Sep 20.
10
Protection of glucagon-like peptide-1 in cisplatin-induced renal injury elucidates gut-kidney connection.阐明肠-肾联系中的胰高血糖素样肽-1 对顺铂诱导的肾损伤的保护作用。
J Am Soc Nephrol. 2013 Dec;24(12):2034-43. doi: 10.1681/ASN.2013020134. Epub 2013 Oct 3.
Zotero 插件