title: Veno-occlusive disease-like hepatotoxicity in two children receiving chemotherapy for Wilms' tumor and clear cell sarcoma of kidney.
abstract: We report two pediatric cases who developed veno-occlusive disease-like hepatotoxicity while receiving chemotherapy for Wilms' tumor and clear cell sarcoma of kidney. The chemotherapeutics, including vincristine, actinomycin D, and epirubicin in case 1 and vincristine and actinomycin D in case 2, were given before the hepatotoxicity developed. Other possible causes of hepatotoxicity were excluded. Recovery was observed with supportive therapy after 2 and 1 weeks, respectively. After recovery, the children tolerated continued chemotherapy without any decrease in the doses of drugs. We conclude that vincristine and actinomycin D were the cause of this rare from of hepatotoxicity and that chemotherapy for the underlying malignant disease could be given safely after clinical recovery.
authors.affiliation: Department of Pediatric Oncology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: V
authors.initials: V
authors.lastname: Hazar
authors.forename: T
authors.initials: T
authors.lastname: Kutluk
authors.forename: C
authors.initials: C
authors.lastname: Akyüz
authors.forename: A
authors.initials: A
authors.lastname: Varan
authors.forename: N
authors.initials: N
authors.lastname: Yariş
authors.forename: M
authors.initials: M
authors.lastname: Büyükpamukçu
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D003609:Dactinomycin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D015251:Epirubicin / Q000008:administration & dosage; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008099:Liver / Q000187:drug effects / Q000473:pathology*; D008297:Male; D018227:Sarcoma, Clear Cell / Q000188:drug therapy*; D014750:Vincristine / Q000008:administration & dosage; D009396:Wilms Tumor / Q000188:drug therapy*
chemical_list: D003609:Dactinomycin; D015251:Epirubicin; D014750:Vincristine