Gemcitabine‑associated thrombotic microangiopathy in a patient with lung cancer: A case report

Lai‑Tiong,Florence; Duval,Yann; Krabansky,Francois

doi:10.3892/ol.2017.5576

Gemcitabine‑associated thrombotic microangiopathy in a patient with lung cancer: A case report

Authors:
- Florence Lai‑Tiong
- Yann Duval
- Francois Krabansky
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Affiliations: Jean Godinot Institute, 51100 Reims, France, Department of Pharmacovigilance and Pharmacoepidemiology, Reims University Hospital, 51100 Reims, France
Published online on: January 5, 2017 https://doi.org/10.3892/ol.2017.5576
Pages: 1201-1203
Copyright: © Lai‑Tiong et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Gemcitabine is frequently used for the treatment of a number of different cancer types. Gemcitabine‑related thrombotic microangiopathy (TMA) has rarely been described, but it is a life‑threatening complication. The incidence of the complication varies between 0.015 and 1.4%. The present study reports the case of a 63‑year‑old Caucasian male who was treated with 3 cycles of carboplatin plus gemcitabine, followed by 7 cycles of gemcitabine only, and developed clinical symptoms that, together with laboratory findings, were compatible with a diagnosis of hemolytic uremic syndrome TMA. The patient was admitted to Jean Godinot Cancer Center Institute with hemolysis, thrombocytopenia, macroscopic hematuria, renal dysfunction and worsening high blood pressure. Medical treatment for the high blood pressure, plasma infusion and hemodialysis were implemented without any improvement in creatine levels. The patient recovered from hematological disorders, left hospital and was followed-up. He required hemodialysis until he succumbed ~3 months subsequent to diagnosis of TMA. Even if thrombocytopenia, anemia and renal failure are common observations in patients treated by chemotherapy, clinicians should be aware of this potentially lethal complication. We recommend screening for TMA in such cases of anemia, thrombocytopenia and renal failure.

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