Gemcitabine-induced chronic systemic capillary leak syndrome
Ravneet Bajwa1, Jason Starr1, Karen Daily1
1Division of Hematology and Oncology, College of Medicine, University of Florida, Gainesville, Florida, USA.
BMJ Case Reports
|September 1, 2017
Summary
A patient with stage II pancreatic cancer developed capillary leak syndrome during gemcitabine treatment. Prompt corticosteroid therapy resolved symptoms, with relapse upon discontinuation, indicating a chronic condition.
Area of Science:
- Oncology
- Nephrology
- Vascular Biology
Background:
- Adjuvant gemcitabine is a standard chemotherapy for pancreatic cancer.
- Capillary leak syndrome (CLS) is a rare but serious adverse effect of chemotherapy.
- Elevated vascular endothelial growth factor (VEGF) is implicated in CLS pathogenesis.
Observation:
- A 56-year-old woman with stage II pancreatic cancer presented with anasarca, hypoalbuminemia, and hypotension after gemcitabine chemotherapy.
- Laboratory investigations revealed elevated VEGF levels (707 pg/mL).
Findings:
- The patient's symptoms resolved completely with corticosteroid treatment.
- Symptom recurrence upon steroid withdrawal strongly suggested chronic capillary leak syndrome.
- Gemcitabine-induced CLS can manifest as a chronic condition.
Implications:
- This case highlights the importance of considering gemcitabine-induced CLS in patients presenting with edema and hypotension during chemotherapy.
- Early recognition and management with corticosteroids may be crucial for patient outcomes.
- Further research into the mechanisms and long-term management of chemotherapy-induced CLS is warranted.
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