Runne U, Doepfmer K, Antz H, Groth W, FEAUX DE Lacroix W
Dtsch Med Wochenschr. 1980 Feb 15;105(7):230-3. doi: 10.1055/s-2008-1070640.
Adjuvant chemo- and immuno-therapy with dacarbazine (1st to 5th day 250 mg/m2 daily) and BCG (6th day 0.01 ml intracutaneously)was administered to a 50-year-old male patient in a three-week cycle after surgical removal of a superficially spreading malignant melanoma. Metoclopramide was used as an antiemetic. During the second therapy cycle sudden severe vascular collapse with increasing hepatomegaly and signs of acute hepatic failure occurred leading to death after two days. At necropsy a Budd-Chiari syndrome with thombosed hepatic veins and congestive liver parenchyma necroses was found. The cause was hyperergic endophlebitis combined with severe infiltration of the vascular walls by eosinophilic granulocytes. In association with 5 more similar cases from other clinics (personal communications) this picture must be assumed to be a complication of dacarbazine treatment.
一名50岁男性患者在手术切除浅表扩散性恶性黑色素瘤后，接受了达卡巴嗪（第1至5天，每日250 mg/m²）和卡介苗（第6天，0.01 ml皮内注射）的辅助化疗和免疫治疗，每三周为一个周期。甲氧氯普胺用作止吐药。在第二个治疗周期中，突然发生严重血管虚脱，肝肿大加重，并出现急性肝衰竭迹象，两天后死亡。尸检发现布加综合征，肝静脉血栓形成，肝实质充血性坏死。病因是过敏性静脉炎，伴有嗜酸性粒细胞严重浸润血管壁。结合其他诊所的另外5例类似病例（个人交流），这种情况应被视为达卡巴嗪治疗的一种并发症。
