title: [A 73-year-old female patient after liver and kidney transplantation with dull pain in the epigastrium and recurrent epistaxis].
abstract: A 73-year-old female patient who had received a liver and kidney transplantation presented with symptomatic pancytopenia and right-sided upper abdominal pain. The histological investigation of a bone marrow biopsy showed the extremely rare manifestation of a disseminated Merkel cell carcinoma with infiltration of the bone marrow and suppression of hematopoiesis. Also a Coombs test positive hemolytic anemia did not show a significant response to high-dose steroid therapy. Palliative chemotherapy with carboplatin and etoposide at reduced dosage had to be terminated due to deterioration of the patient's general condition. The patient died 2 days after initiation of chemotherapy.
authors: I. Medizinische Klinik, Zentrum für Innere Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland, m.zinser@uke.de.
authors: M E
authors: ME
authors: Zinser
authors: H J F
authors: HJ
authors: Salzer
authors: A
authors: A
authors: Stein
authors: M
authors: M
authors: von Petersdorff
authors: A
authors: A
authors: Koops
authors: J
authors: J
authors: Holzhüter
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015266:Carcinoma, Merkel Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D003131:Combined Modality Therapy / Q000009:adverse effects; D003937:Diagnosis, Differential; D004844:Epistaxis / Q000175:diagnosis / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D012008:Recurrence
chemical_list: D000970:Antineoplastic Agents