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Case report: cisplatin-induced hemolytic uremic syndrome
The American Journal of the Medical Sciences
|June 1, 1991
Summary
Red blood cell transfusions can cause noncardiogenic pulmonary edema (NCPE) in patients with acute cisplatin nephropathy, potentially linked to hemolytic uremic syndrome (HUS). Caution is advised during transfusions for acute kidney injury patients.
Area of Science:
- Nephrology
- Oncology
- Hematology
Background:
- Cisplatin is a platinum-based chemotherapy agent used in cancer treatment.
- Nephropathy is a common dose-limiting toxicity of cisplatin.
- Noncardiogenic pulmonary edema (NCPE) and hemolytic uremic syndrome (HUS) are potential complications.
Observation:
- Two patients with acute cisplatin nephropathy developed NCPE post-red blood cell transfusion.
- One patient presented with full HUS, the other with transient HUS-like features.
- A third NCPE case was found in acute renal dysfunction, but not in stable chronic renal impairment.
Findings:
- Acute cisplatin nephropathy, particularly with acute renal dysfunction, is a risk factor for transfusion-related NCPE and HUS.
- Mild chronic renal impairment from cisplatin did not show similar transfusion complications.
- Hemolytic uremic syndrome may be a rare manifestation of cisplatin toxicity.
Implications:
- Transfusing patients with acute cisplatin nephropathy requires caution, even without overt microangiopathy.
- The exact pathogenesis of transfusion-induced NCPE and HUS in this context remains unclear.
- Further research is needed to understand the mechanisms and guide clinical management.