[A case of pulmonary adenocarcinoma accompanied by minimal change nephrotic syndrome, antiphospholipid syndrome and warm-type autoimmune hemolytic anemia].

Abstract

A 49-year-old man was urgently admitted due to edema in both leg and left toe pain. A chest radiograph revealed a solitary nodule in the right lung field. Detailed investigations including bronchoscopy and renal biopsy led to a simultaneous diagnosis of clinical stage IIIB pulmonary adenocarcinoma, minimal change nephrotic syndrome, antiphospholipid syndrome, and warm-type autoimmune hemolytic anemia. Prednisolone was administered for nephrotic syndrome, antiphospholipid syndrome and warm-type autoimmune hemolytic anemia, and 6 courses of chemotherapy with 70Gy radio-therapy were performed. The pulmonary nodule significantly decreased in size and the other three autoimmune diseases appeared to be well-controlled. Thirteen months after admission, multiple brain metastases developed along with worsening antiphospholipid syndrome symptoms including lupus anticoagulant. Following whole-brain irradiation, the brain metastases decreased in size and antiphospholipid syndrome symptoms improved. Thirty-nine months after the initial visit, the primary lung cancer, its brain metastasis and the 3 other autoimmune diseases appeared to be well-controlled. The temporal correlation of the lung cancer and the three autoimmune diseases suggests the latter may be paraneoplastic syndrome.

• Authors: Shinji Miyajima, Yoshio Taguchi, Eisaku Tanaka, Tetsuro Inoue, Minoru Sakuramoto, Masayoshi Minakuchi, Yuji Maeda, Ko Maniwa, Kiminobu Tanizawa, Masaki Okamoto, Tomoshi Takeda
• Journal: Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society (Nihon Kokyuki Gakkai Zasshi) Vol. 44 Issue 9 Pg. 631-5 (Sep 2006) ISSN: 1343-3490 [Print] Japan
• PMID: 17037407 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Prednisolone
• Carboplatin
• Paclitaxel

Topics

• Adenocarcinoma (complications, drug therapy, secondary)
• Anemia, Hemolytic, Autoimmune (drug therapy, etiology)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Antiphospholipid Syndrome (drug therapy, etiology)
• Brain Neoplasms (radiotherapy, secondary)
• Carboplatin (administration & dosage)
• Cranial Irradiation
• Drug Administration Schedule
• Humans
• Lung Neoplasms (complications, drug therapy, pathology)
• Male
• Middle Aged
• Nephrosis, Lipoid (drug therapy, etiology)
• Paclitaxel (administration & dosage)
• Prednisolone (administration & dosage)