title: Cisplatin-associated hemolytic-uremic syndrome. Successful treatment with a staphylococcal protein A column.
abstract: Cisplatin-associated hemolytic-uremic syndrome (HUS), an under-reported form of HUS induced by chemotherapy, typically pursues a fulminant and lethal course. We report the cases of two patients with squamous cell carcinoma of the head and neck who developed massive hemolysis, profound thrombocytopenia, and dialysis-dependent renal failure after therapy with cisplatin. Plasma exchange was ineffective in both patients, but plasma perfusion with a staphylococcal protein A column produced a dramatic and permanent response in the second patient. These cases show the importance of considering HUS as a cause of renal failure in such patients who receive cisplatin-based chemotherapy, and support the role of staphylococcal protein A plasma perfusion as treatment for this condition.
authors.affiliation: Medical College of Georgia, Augusta 30912.
authors.forename: P R
authors.initials: PR
authors.lastname: Watson
authors.forename: T H
authors.initials: TH
authors.lastname: Guthrie
authors.forename: R J
authors.initials: RJ
authors.lastname: Caruana
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000188:drug therapy; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000188:drug therapy; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D007105:Immune Complex Diseases / Q000209:etiology / Q000628:therapy*; D007822:Laryngeal Neoplasms / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D010477:Perfusion; D013205:Staphylococcal Protein A
chemical_list: D013205:Staphylococcal Protein A; D002945:Cisplatin