title: Drug-induced thrombotic thrombocytopenic purpura successfully treated with recombinant human soluble thrombomodulin.
abstract: A 61-year-old woman with recurrent non-small cell lung cancer presented with thrombocytopenia, microangiopathic hemolytic anemia, neurological abnormalities, renal failure and a fever that appeared during chemotherapy with gemcitabine and bevacizumab. She was diagnosed with drug-induced thrombotic thrombocytopenic purpura (TTP). After the discontinuation of chemotherapy, the administration of recombinant human soluble thrombomodulin and fresh-frozen plasma rapidly ameliorated the TTP. Hypertension preceded the onset of TTP and required the administration of quadruple therapy on admission. However, after three months, the hypertension was controllable without anti-hypertensive drugs. Twelve months later, the ninth course of vinorelbine was administered safely, preventing the patient's lung cancer from progressing.
authors.affiliation: Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Nishijima
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Hirata
authors.forename: Aiko
authors.initials: A
authors.lastname: Himeno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kida
authors.forename: Masanori
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Ryo
authors.initials: R
authors.lastname: Takahashi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Otani
authors.forename: Kouji
authors.initials: K
authors.lastname: Inoue
authors.forename: Izumi
authors.initials: I
authors.lastname: Nagatomo
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Takeda
authors.forename: Takashi
authors.initials: T
authors.lastname: Kijima
authors.forename: Isao
authors.initials: I
authors.lastname: Tachibana
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fujimura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kumanogoh
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000068258:Bevacizumab; D018287:Carcinoma, Large Cell / Q000150:complications / Q000188:drug therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077143:Docetaxel; D000069347:Erlotinib Hydrochloride; D005260:Female; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D000068437:Pemetrexed; D010949:Plasma; D011697:Purpura, Thrombotic Thrombocytopenic / Q000139:chemically induced / Q000188:drug therapy* / Q000628:therapy; D011725:Pyridines / Q000008:administration & dosage; D011799:Quinazolines / Q000008:administration & dosage; D011994:Recombinant Proteins / Q000627:therapeutic use; D012995:Solubility; D043823:Taxoids / Q000008:administration & dosage; D005641:Tegafur / Q000008:administration & dosage; D018180:Thrombomodulin / Q000627:therapeutic use*; D000093542:Gemcitabine
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000959:Antihypertensive Agents; D005971:Glutamates; D011725:Pyridines; D011799:Quinazolines; D011994:Recombinant Proteins; C546931:THBD protein, human; D043823:Taxoids; D018180:Thrombomodulin; D000068437:Pemetrexed; D003841:Deoxycytidine; D005641:Tegafur; D000077143:Docetaxel; D000068258:Bevacizumab; D010094:Oxonic Acid; D006147:Guanine; D000069347:Erlotinib Hydrochloride; D002945:Cisplatin; C104201:gimeracil; D000093542:Gemcitabine