title: [A case of pulmonary adenocarcinoma accompanied by minimal change nephrotic syndrome, antiphospholipid syndrome and warm-type autoimmune hemolytic anemia].
abstract: A 49-year-old man was urgently admitted due to edema in both leg and left toe pain. A chest radiograph revealed a solitary nodule in the right lung field. Detailed investigations including bronchoscopy and renal biopsy led to a simultaneous diagnosis of clinical stage IIIB pulmonary adenocarcinoma, minimal change nephrotic syndrome, antiphospholipid syndrome, and warm-type autoimmune hemolytic anemia. Prednisolone was administered for nephrotic syndrome, antiphospholipid syndrome and warm-type autoimmune hemolytic anemia, and 6 courses of chemotherapy with 70Gy radio-therapy were performed. The pulmonary nodule significantly decreased in size and the other three autoimmune diseases appeared to be well-controlled. Thirteen months after admission, multiple brain metastases developed along with worsening antiphospholipid syndrome symptoms including lupus anticoagulant. Following whole-brain irradiation, the brain metastases decreased in size and antiphospholipid syndrome symptoms improved. Thirty-nine months after the initial visit, the primary lung cancer, its brain metastasis and the 3 other autoimmune diseases appeared to be well-controlled. The temporal correlation of the lung cancer and the three autoimmune diseases suggests the latter may be paraneoplastic syndrome.
authors.affiliation: Department of Respiratory Medicine, Tenri Yorodu Soudansho Hospital.
authors.forename: Shinji
authors.initials: S
authors.lastname: Miyajima
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Taguchi
authors.forename: Eisaku
authors.initials: E
authors.lastname: Tanaka
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Inoue
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuramoto
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Minakuchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Maeda
authors.forename: Ko
authors.initials: K
authors.lastname: Maniwa
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Tanizawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Okamoto
authors.forename: Tomoshi
authors.initials: T
authors.lastname: Takeda
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000188:drug therapy / Q000556:secondary; D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy / Q000209:etiology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000188:drug therapy / Q000209:etiology*; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary; D016190:Carboplatin / Q000008:administration & dosage; D016371:Cranial Irradiation; D004334:Drug Administration Schedule; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000188:drug therapy / Q000209:etiology*; D017239:Paclitaxel / Q000008:administration & dosage; D011239:Prednisolone / Q000008:administration & dosage
chemical_list: D011239:Prednisolone; D016190:Carboplatin; D017239:Paclitaxel