Thrombotic microangiopathy following docetaxel and trastuzumab chemotherapy: a case report.
Thrombotic microangiopathy is a rare haematological emergency which encompasses the conditions of haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP). It is an unusual but recognised complication of chemotherapy. It has not previously been described in conjunction with docetaxel or trastuzumab therapy. We report a 47-year-old patient with localised breast cancer who developed thrombotic microangiopathy (HUS/TTP) acutely following concurrent neoadjuvant therapy with trastuzumab and docetaxel. We demonstrate from our case that mild confusion occurring on a background of mild anaemia and thrombocytopenia may sometimes be the only clue to the diagnosis. Clinicians should be aware of the possibility of thrombotic microangiopathy associated with trastuzumab and docetaxel therapy, as early intervention can improve clinical outcome.
Department of Medicine, Great Western Hospital, SN3 6BB, Swindon, UK. keith@siau.org
Keith
K
Siau
Mohini
M
Varughese
D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000473:pathology; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage; D057049:Thrombotic Microangiopathies / Q000139:chemically induced*; D000068878:Trastuzumab; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D043823:Taxoids; D000077143:Docetaxel; D000068878:Trastuzumab