Wu D C, Liu J M, Chen Y M, Yang S, Liu S M, Chen L T, Whang-Peng J
Department of Internal Medicine, Veterans' General Hospital-Taipei, Taiwan, Republic of China.
Jpn J Clin Oncol. 1997 Apr;27(2):115-8. doi: 10.1093/jjco/27.2.115.
Hemolytic uremic syndrome spontaneously arises in a few patients with advanced cancer, but it is more commonly related to the use of certain chemotherapeutic agents. Mitomycin-C is, etiologically, the most common causative agent inducing hemolytic uremic syndrome, in a dose dependent manner. We report this syndrome, attributable to mitomycin-C at a cumulative dose of 40 mg/m2, in a gastric cancer patient. A 42-year-old female with stage III gastric cancer underwent radical gastrectomy and was given mitomycin-C at 10 mg/m2 intravenously every four weeks as adjuvant therapy. Hemolytic uremic syndrome was diagnosed three months after the last dose of mitomycin-C administration. The most prominent symptoms included pallor, hypertension and anasarca, with laboratory evidence of microangiopathic hemolytic anemia, azotemia and hyperkalemia. Her disease was progressive, but fortunately stabilized after staphylococcus column A dialysis. Her disease remained in remission for 24 months from the time of diagnosis, and then relapsed in the form of peritoneal carcinomatosis with partial intestinal obstruction.
溶血性尿毒症综合征在少数晚期癌症患者中自发出现，但更常见于使用某些化疗药物后。从病因学角度来看，丝裂霉素-C是诱导溶血性尿毒症综合征最常见的致病因素，且呈剂量依赖性。我们报告了一名胃癌患者因累积剂量达40mg/m²的丝裂霉素-C引发该综合征的病例。一名42岁的III期胃癌女性患者接受了根治性胃切除术，并每四周静脉注射10mg/m²丝裂霉素-C作为辅助治疗。在最后一剂丝裂霉素-C给药三个月后诊断出溶血性尿毒症综合征。最突出的症状包括面色苍白、高血压和全身水肿，实验室检查显示有微血管病性溶血性贫血、氮质血症和高钾血症。她的病情呈进行性发展，但幸运的是在进行A群葡萄球菌柱透析后病情稳定。自诊断之时起，她的病情缓解了24个月，随后以腹膜癌病伴部分肠梗阻的形式复发。
