title: [Clinical efficacy of eculizumab as treatment of gemcitabine-induced thrombotic microangiopathy: A case report].
abstract: BACKGROUND
  Gemcitabine-induced thrombotic microangiopathy is a rare event whose management is not yet consensual. The use of eculizumab could be of interest.
  
  
  METHODS
  A 68-year-old woman was treated by gemcitabine as adjuvant chemotherapy of a pancreatic adenocarcinoma. Two months later, the patient presented with mechanical hemolytic anemia, thrombocytopenia and high blood pressure that led to the diagnosis of thrombotic microangiopathy. Gemcitabine was stopped. Plasma exchange therapy was introduced since hematological and renal parameters had worsened. As clinical efficacy was insufficient, eculizumab was introduced at a dose of 900 mg per week 4 times, then 1200 mg every 2 weeks. Symptoms along with hematological and nephrological analysis were back to physiological standards after 7 intravenous injections.
  
  
  CONCLUSIONS
  Eculizumab seems to be an effective treatment against gemcitabine-induced thrombotic microangiopathy in case of severe hematological and renal injuries associated with a lack of response to plasma exchange therapy.
authors.affiliation: Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: T
authors.initials: T
authors.lastname: Rogier
authors.affiliation: Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: M
authors.initials: M
authors.lastname: Gerfaud-Valentin
authors.affiliation: Service de transplantation, de néphrologie et d'immunologie clinique, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Pouteil-Noble
authors.affiliation: Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: A
authors.initials: A
authors.lastname: Taleb
authors.affiliation: Service d'hépato-gastro-entérologie et de nutrition clinique, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: M
authors.initials: M
authors.lastname: Guillet
authors.affiliation: Service de réanimation médicale, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: A
authors.initials: A
authors.lastname: Noel
authors.affiliation: Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: C
authors.initials: C
authors.lastname: Broussolle
authors.affiliation: Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France. Electronic address: pascal.seve@chu-lyon.fr.
authors.forename: P
authors.initials: P
authors.lastname: Sève
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D010190:Pancreatic Neoplasms / Q000188:drug therapy; D057049:Thrombotic Microangiopathies / Q000139:chemically induced* / Q000188:drug therapy*; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D003841:Deoxycytidine; C481642:eculizumab; D000093542:Gemcitabine
keywords: Atypical hemolytic and uremic syndrome; Eculizumab; Gemcitabine; Microangiopathie thrombotique; Syndrome hémolytique et urémique atypique; Thrombotic microangiopathy; Éculizumab