title: Thrombotic microangiopathy with renal failure in two patients undergoing gemcitabine chemotherapy.
abstract: Described here are 2 patients who developed thrombotic microangiopathy of the kidneys after receiving high cumulative doses of the new anticancer drug gemcitabine. The first patient, who received gemcitabine for treatment of a carcinoma of the pancreas, required hemodialysis for 6 months. In the second case, a woman suffering from a cholangiocellular carcinoma, end-stage renal disease was irreversible. Clinical awareness, timely detection and discontinuation of gemcitabine are mandatory to prevent this rare but disastrous complication of gemcitabine therapy.
authors.affiliation: Department of Internal Medicine, Innsbruck University Hospital, Innsbruck, Austria. Karl.Lhotta@uibk.ac.at
authors.forename: K
authors.initials: K
authors.lastname: Lhotta
authors.forename: T
authors.initials: T
authors.lastname: Kühr
authors.forename: H J
authors.initials: HJ
authors.lastname: Rumpelt
authors.forename: E
authors.initials: E
authors.lastname: Wöll
authors.forename: J
authors.initials: J
authors.lastname: Thaler
authors.forename: P
authors.initials: P
authors.lastname: König
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D001650:Bile Duct Neoplasms / Q000188:drug therapy / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D001707:Biopsy, Needle; D018281:Cholangiocarcinoma / Q000188:drug therapy / Q000473:pathology; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D017809:Fatal Outcome; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D007678:Kidney Glomerulus / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology; D006435:Renal Dialysis; D012264:Ribonucleotide Reductases / Q000037:antagonists & inhibitors; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D012264:Ribonucleotide Reductases; D000093542:Gemcitabine