title: [A 42-year-old patient with the hemolytic-uremic syndrome under gemcitabine therapy for an adenocarcinoma of the liver. The hemolytic-uremic syndrome and gemcitabine].
abstract: We report on the case of a 42-year-old man suffering from an irresectable adenocarcinoma of the liver. The patient was treated with 5-fluorouracil for 6 months when the disease progressed and second line therapy with gemcitabine was started. After 4 months diastolic blood pressure increased and edema of the legs as well as vomiting occurred. Laboratory tests revealed anemia and thrombopenia accompanied by an elevation of plasma D-dimer, lactatdehydrogenase, creatinine, and urea levels in the serum. In addition, a pronounced proteinuria as well as renal hematuria were detected and subsequently a hemolytic uremic syndrome was diagnosed. After treatment with high-dose glucocorticoids, anticoagulants and transfusions of packed RBC the course of disease improved. Since Gemcitabine is now widely used for treatment of solid organ cancer (e.g. pancreatic adenocarcinoma, biliary tract cancer, lung cancer etc.), it is necessary to be aware of Gemcitabine-induced hemolytic uremic syndrome as a rare but potentially fatal side effect.
authors.affiliation: II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München. florian.eckel@lrz.tum.de
authors.forename: F
authors.initials: F
authors.lastname: Eckel
authors.forename: C
authors.initials: C
authors.lastname: Lersch
authors.forename: J
authors.initials: J
authors.lastname: Erdmann
authors.forename: B
authors.initials: B
authors.lastname: Schmidt
authors.forename: E
authors.initials: E
authors.lastname: Schulte-Frohlinde
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000175:diagnosis; D000230:Adenocarcinoma / Q000150:complications* / Q000188:drug therapy; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D018450:Disease Progression; D017809:Fatal Outcome; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000188:drug therapy; D008297:Male; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine