title: High cutoff membrane to reduce systemic inflammation due to differentiation syndrome: a case report.
abstract: BACKGROUND
  Differentiation syndrome is a life-threatening complication of therapy that is carried out with agents used for acute promyelocytic leukemia. Its physiopathology comprehends the production of inflammatory mediators by differentiating granulocytes, endothelial and alveolar cells due to stimulation by all-trans retinoic acid and leading to sustained systemic inflammation.
  
  
  METHODS
  Treatment with high cut-off continuous veno-venous hemodialysis (HCO-CVVHD) was performed to reduce the circulating mediators of systemic inflammation.
  
  
  RESULTS
  After 52 h of treatment, an important reduction was observed in inflammatory mediators (IL-1β: from 10 to 2 pg/ml; IL-8: from 57 to 40 pg/ml; TNF-α: from 200 to 105 pg/ml; IL-6: from 263 to 91 pg/ml), as well as in anti-inflammatory mediators (IL-10: from 349 to 216 pg/ml).
  
  
  CONCLUSIONS
  HCO-CVVHD should be explored as a part of treatment in systemic inflammation states other than sepsis (e.g., differentiation syndrome). Furthermore, its immunomodulatory effects could be particularly useful in immunocompromised patient treated with corticosteroids.
authors.affiliation: International Renal Research Institute of Vicenza, Vicenza, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Villa
authors.forename: Jose J
authors.initials: JJ
authors.lastname: Zaragoza
authors.forename: Aashish
authors.initials: A
authors.lastname: Sharma
authors.forename: Cosimo
authors.initials: C
authors.lastname: Chelazzi
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.forename: A Raffaele
authors.initials: AR
authors.lastname: De Gaudio
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology / Q000628:therapy; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D019355:Calcium Citrate / Q000627:therapeutic use; D019559:Capillary Leak Syndrome / Q000139:chemically induced* / Q000628:therapy; D002454:Cell Differentiation / Q000187:drug effects; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy / Q000209:etiology; D017809:Fatal Outcome; D006440:Hemofiltration / Q000295:instrumentation*; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D056747:Immunomodulation; D007249:Inflammation / Q000097:blood / Q000139:chemically induced / Q000628:therapy*; D018836:Inflammation Mediators / Q000097:blood*; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008567:Membranes, Artificial; D008970:Molecular Weight; D010539:Permeability; D011239:Prednisolone / Q000008:administration & dosage; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000209:etiology; D012709:Serum Albumin / Q000032:analysis; D013577:Syndrome; D014212:Tretinoin / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000925:Anticoagulants; D018836:Inflammation Mediators; D008567:Membranes, Artificial; D012709:Serum Albumin; D014212:Tretinoin; D011239:Prednisolone; D019355:Calcium Citrate; D015255:Idarubicin