Carboplatin-associated thrombotic microangiopathic hemolytic anemia.
Thrombotic microangiopathic hemolytic anemia has been associated with several chemotherapeutic agents. The authors describe a patient who developed this syndrome while receiving carboplatin, an analog of cisplatin. The clinical course was marked by encephalopathy and multifocal neurologic deficits. Progressive brainstem dysfunction culminated in coma and respiratory arrest. Pathologic examination revealed widespread microvascular thrombosis, particularly severe in the heart, kidney, and brain. Although the pathogenesis of chemotherapy-related thrombotic microangiopathy remains unclear, an elevated von Willebrand factor antigen and pathologic evidence of endothelial hyperplasia in this patient suggest that an abnormality of the endothelium is related to the development of the clinical syndrome.
Walker
R W
RW
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Rosenblum
M K
MK
Kempin
S J
SJ
Christian
M C
MC
D000743:Anemia, Hemolytic / Q000139:chemically induced* / Q000473:pathology; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001158:Arteries / Q000473:pathology; D001160:Arterioles / Q000473:pathology; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002196:Capillaries / Q000473:pathology; D016190:Carboplatin; D002528:Cerebellar Neoplasms / Q000188:drug therapy; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000473:pathology; D008527:Medulloblastoma / Q000188:drug therapy; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D013927:Thrombosis / Q000139:chemically induced* / Q000473:pathology
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D016190:Carboplatin