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Published on: November 7, 2019
Gemcitabine induced hemolytic uremic syndrome
Seyed-Ali Sadjadi1, Pavan Annamaraju
1Nephrology Section, Jerry L. Pettis Memorial Veterans Medical Center, Loma Linda, CA, U.S.A ; Loma Linda University School of Medicine, Loma Linda, CA, U.S.A.
The American Journal of Case Reports
|April 10, 2013
Summary
Gemcitabine chemotherapy can cause hemolytic uremic syndrome (HUS), a serious condition. Careful patient monitoring is crucial during cancer treatment to detect and manage this adverse effect.
Area of Science:
- Oncology
- Nephrology
- Hematology
Background:
- Gemcitabine is a common chemotherapy agent for various cancers.
- Gemcitabine can induce hemolytic uremic syndrome (HUS), characterized by hemolytic anemia and acute kidney injury.
- Other potential HUS manifestations include edema, livedo reticularis, and digital necrosis.
Purpose of the Study:
- To report a case of gemcitabine-induced hemolytic uremic syndrome in a patient with non-small cell lung cancer.
- To highlight the clinical presentation and management challenges of this adverse event.
Main Methods:
- A case study of a 78-year-old male patient with non-small cell lung cancer is presented.
- The patient received multiple chemotherapy agents, including gemcitabine.
- Treatment involved aggressive hemodialysis and plasmapheresis, followed by splenectomy.
Main Results:
- The patient developed hemolytic uremic syndrome during chemotherapy.
- Initial response to hemodialysis and plasmapheresis was observed.
- Relapse of hemolysis occurred upon reducing plasmapheresis frequency, indicated by increased lactate dehydrogenase and decreased platelets.
- Splenectomy led to resolution of hemolysis, but hemodialysis was still required.
Conclusions:
- Gemcitabine-induced HUS is a recognized but not fully understood complication.
- The pathogenesis of gemcitabine-induced HUS requires further investigation.
- Cautious use of gemcitabine, with vigilant renal function monitoring and patient observation, is essential.
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