Hypofibrinogenemia in a girl with Langerhans cell histiocytosis during etoposide and prednisolone therapy.
A case of a girl with Langerhans cell histiocytosis who had hypofibrinogenemia during etoposide (VP-16) and prednisolone therapy is described. A patient on a three times per week schedule of 100 mg/m2 etoposide in combination with 40 mg/m2 of prednisolone every day had hypofibrinogenemia of 90 mg/dL after 12 doses of etoposide. Hypofibrinogenemia improved after discontinuing the course of etoposide. The clinical course suggested that the combination of etoposide with prednisolone caused this side-effect. Although the exact mechanism of toxicity of etoposide with prednisolone remains unknown, it is possible that the side-effect might be due to reduced production of fibrinogen in the liver. Careful monitoring of fibrinogen is mandatory in patients receiving etoposide and prednisolone.
Miura
T
T
Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan.
Nakamura
M
M
Tsunematsu
Y
Y
Fujimoto
J
J
Meguro
T
T
Yamada
K
K
D000347:Afibrinogenemia / Q000097:blood / Q000139:chemically induced*; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D011859:Radiography
D005047:Etoposide; D011239:Prednisolone