title: Withdrawal of interferon-alpha results in prompt resolution of thrombocytopenia and hemolysis but not renal failure in hemolytic uremic syndrome caused by interferon-alpha.
abstract: This case report describes 2 patients with chronic myeloid leukemia in whom hemolytic uremic syndrome developed while being treated with interferon-alpha and hydroxycarbamide. Hemolytic uremic syndrome was recognized by progressive renal dysfunction, thrombocytopenia, microangiopathic hemolytic anemia, and histologic features of thrombotic microangiopathy in the kidney. Although renal dysfunction progressed to dialysis-dependent renal failure in one patient despite treatment with prednisolone and plasmapheresis but not in other, withdrawal of the treatment resulted in a prompt resolution of thrombocytopenia and microangiopathic hemolytic anemia in both patients.
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, and Seirei Hamamatsu General Hospital, Hamamatsu, Japan. ohashi-n@hama-med.ac.jp
authors.forename: Naro
authors.initials: N
authors.lastname: Ohashi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yonemura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugiura
authors.forename: Taisuke
authors.initials: T
authors.lastname: Isozaki
authors.forename: Akashi
authors.initials: A
authors.lastname: Togawa
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Fujigaki
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Hishida
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D006461:Hemolysis / Q000187:drug effects*; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000188:drug therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D010951:Plasma Exchange / Q000379:methods; D020551:Pulse Therapy, Drug; D006435:Renal Dialysis / Q000379:methods; D013921:Thrombocytopenia / Q000139:chemically induced*
chemical_list: D016898:Interferon-alpha; D008775:Methylprednisolone; D006918:Hydroxyurea