[Drug induced hemolytic uremic syndrome]

Several drugs including antineoplastic drugs and immunosuppressant can induce hemolytic uremic syndrome. Mitomycin C are well known to cause cancer associated HUS, and its frequency are reported to be 4-15%. Noncardiogenic pulmonary edema frequently ( > 50%) develops, especially after blood transfusion, among MMC induced HUS. Cancer associated HUS has a high mortality and no effective therapy has been established. Combination of vinblastin and bleomycin also induces HUS. Cisplatin, one of the most frequently used antineoplastic drugs, also induces HUS. Cyclosporin causes HUS, probably due to endothelial damage and/or an inhibition of prostacyclin synthesis. A case of FK506 induced HUS has been recently reported. Quinine and Cocaine also can induce HUS. Prognosis of cancer associated HUS is quite poor, whereas Quinine and Cocaine induced HUS may resolve.