[Atypical hemolytic uremic syndrome related to Oxalyplatin Cancer Chemotherapy responsive to Eculizumab].
We describe the case of a patient with adenocarcinoma of the colon treated with FOLFOX-4 (5-Fluorouracil, Folinic acid, Oxalyplatin), with subsequent appearance of atypical hemolytic uremic syndrome (aHUS). From 1999 to 2009, 13 cases of atypical HUS receiving chemotherapy with oxaliplatin have been described, as well as some sporadic cases. None of these cases has been treated with eculizumab. This is the first report of a patient with aHUS secondary to Oxalyplatin treated with Eculizumab. This treatment induced a complete remission of the syndrome and, later on, it has been discontinued with clinical and laboratory permanent remission. We identified some genetic mutations in this patient that might have a pathogenic role in the determining aHUS when associated with exposure to Oxalyplatin. Oxalyplatin withdrawal and its replacement to Irinotecan allowed the patient to receive first line chemotherapy continuation (FOLFIRI) with the same life expectancy and the same symptoms free period.
Fulvia
F
Zanchelli
Elena
E
Tampieri
Francesco
F
Gozzetti
Mattia
M
Monti
Davide
D
Martelli
Romina
R
Graziani
Eliana
E
Zuffa
Daniele
D
Vincenzi
Alessandro
A
Gamboni
Andrea
A
Buscaroli
D000230:Adenocarcinoma / Q000188:drug therapy; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D065766:Atypical Hemolytic Uremic Syndrome / Q000139:chemically induced* / Q000188:drug therapy*; D003110:Colonic Neoplasms / Q000188:drug therapy; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D011725:Pyridines / Q000009:adverse effects*; D012074:Remission Induction
D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D011725:Pyridines; C431073:oxiplatin; C481642:eculizumab; D002955:Leucovorin; D005472:Fluorouracil