title: Mitomycin-C induced hemolytic uremic syndrome: a case report and literature review.
abstract: Hemolytic uremic syndrome spontaneously arises in a few patients with advanced cancer, but it is more commonly related to the use of certain chemotherapeutic agents. Mitomycin-C is, etiologically, the most common causative agent inducing hemolytic uremic syndrome, in a dose dependent manner. We report this syndrome, attributable to mitomycin-C at a cumulative dose of 40 mg/m2, in a gastric cancer patient. A 42-year-old female with stage III gastric cancer underwent radical gastrectomy and was given mitomycin-C at 10 mg/m2 intravenously every four weeks as adjuvant therapy. Hemolytic uremic syndrome was diagnosed three months after the last dose of mitomycin-C administration. The most prominent symptoms included pallor, hypertension and anasarca, with laboratory evidence of microangiopathic hemolytic anemia, azotemia and hyperkalemia. Her disease was progressive, but fortunately stabilized after staphylococcus column A dialysis. Her disease remained in remission for 24 months from the time of diagnosis, and then relapsed in the form of peritoneal carcinomatosis with partial intestinal obstruction.
authors.affiliation: Department of Internal Medicine, Veterans' General Hospital-Taipei, Taiwan, Republic of China.
authors.forename: D C
authors.initials: DC
authors.lastname: Wu
authors.forename: J M
authors.initials: JM
authors.lastname: Liu
authors.forename: Y M
authors.initials: YM
authors.lastname: Chen
authors.forename: S
authors.initials: S
authors.lastname: Yang
authors.forename: S M
authors.initials: SM
authors.lastname: Liu
authors.forename: L T
authors.initials: LT
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Whang-Peng
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D005260:Female; D005743:Gastrectomy; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced*; D006801:Humans; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin