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.
Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan.
T
T
Miura
M
M
Nakamura
Y
Y
Tsunematsu
J
J
Fujimoto
T
T
Meguro
K
K
Yamada
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