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Oxaliplatin-induced thrombotic microangiopathy: a case report
Rhea Saad1, Audra Hannun1, Sally Temraz1
1American University of Beirut Medical Center, Beirut, Lebanon.
Journal of Medical Case Reports
|March 19, 2022
Summary
Oxaliplatin chemotherapy can rarely cause severe hemolytic-uremic syndrome (HUS), a life-threatening condition. Prompt diagnosis and treatment are crucial for patient recovery from this rare adverse event.
Area of Science:
- Oncology
- Nephrology
- Hematology
Background:
- Oxaliplatin is a standard chemotherapy for metastatic colorectal cancer.
- Thrombotic microangiopathies are rare but serious adverse events associated with oxaliplatin treatment.
- This case highlights a rare instance of fulminant oxaliplatin-induced thrombotic microangiopathy.
Observation:
- A 73-year-old female developed symptoms hours after oxaliplatin re-administration.
- Clinical presentation included microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure, suggestive of HUS.
- Severe renal failure was a predominant feature, mimicking HUS.
Findings:
- The rapid onset of thrombotic microangiopathy was directly linked to oxaliplatin exposure.
- A dose-dependent, drug-induced toxicity mechanism is proposed for this oxaliplatin complication.
- The patient experienced a progressive recovery following plasma exchange, corticosteroids, and supportive care.
Implications:
- Physicians must maintain high clinical suspicion for HUS in patients receiving oxaliplatin.
- Early diagnosis and intervention are critical for managing this potentially fatal complication.
- This case underscores the importance of recognizing rare toxicities of standard chemotherapies.
