[Mitomycin-induced hemolytic-uremic syndrome].

Abstract

HISTORY AND CLINICAL FINDINGS:

A 58-year-old patient suffered from rapidly progressing renal insufficiency and 11 kg weight-loss three months after adjuvant treatment of a carcinoma of the lower bowel (G 2 T 3 N 1 M 0 ) with mitomycine C. At the point of hospitalisation the patient was anuric while suffering from pulmonary oedema, hemolytic anemia and thrombocytopenia.

INVESTIGATIONS:

Computed tomography and bronchial endoscopy showed pulmonary haemorrhage. Recurrence of carcinoma or metastases were excluded. Renal biopsy revealed mesangiolysis and concentric intimaproliferation (onion skinning). Beside haemolytic anaemia and fragmentocytes toxic damage of the bone marrow was found.

TREATMENT AND COURSE:

After one week treatment in the intensive care unit because of respiratory insufficiency recovery was observed under plasma separation and high dose corticosteroid therapy. Disease activity involved renal failure, bone marrow insufficiency, microangiopathic anaemia thrombopenia and pulmonary haemorrhage.

CONCLUSION:

Lung involvement in the course of haemolytic uremic syndrome is rare and carries a high lethality. The case illustrates the need of detailed diagnostic for correct treatment of haemolytic uremic syndrome. If chemotherapy is required in patients with pre-existing or intercurrent renal failure dose adaptation is necessary to avoid dose-dependent toxicity of mitomycine C.

• Authors: G Zeller, E Wandel, A Schwarting
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 128 Issue 25-26 Pg. 1399-402 (Jun 20 2003) ISSN: 0012-0472 [Print] Germany
• Vernacular Title: Mitomycininduziertes hämolytisch-urämisches Syndrom.
• PMID: 12813674 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antibiotics, Antineoplastic
• Mitomycin

Topics

• Antibiotics, Antineoplastic (adverse effects, therapeutic use)
• Chemotherapy, Adjuvant
• Hemolytic-Uremic Syndrome (chemically induced, complications, pathology)
• Hemorrhage (diagnosis, etiology)
• Humans
• Lung Diseases (diagnosis, etiology)
• Male
• Middle Aged
• Mitomycin (adverse effects, therapeutic use)
• Prognosis
• Sigmoid Neoplasms (drug therapy, surgery)