Hemolytic uremic syndrome due to gemcitabine in a young woman with cholangiocarcinoma

Abstract Gemcitabine is a medication used to treat various types of malignant neoplasms. Its association with hemolytic uremic syndrome (HUS) has been described in few cases, although these cases have resulted in mortality rates of at least 50%. We report on the case of a 25-year-old patient with cholangiocarcinoma in remission who developed microangiopathic hemolytic anemia with acute anuric renal failure after receiving 5 cycles of gemcitabine chemotherapy; this condition was consistent with HUS caused by the side effects of this drug. The administration of gemcitabine was stopped, and hemodialysis, blood transfusions, plasma exchanges, steroids, doxycycline, and rituximab were used to treat the patient. A favorable outcome was achieved; in particular, hemolysis was controlled, and renal function was completely recovered.

摘要：吉西他滨（Gemcitabine）是一种用于治疗多种恶性肿瘤的临床药物。尽管已有少数病例报道提及该药与溶血性尿毒症综合征（hemolytic uremic syndrome, HUS）相关，但此类病例的病死率至少可达50%。本文报告1例病例：一名处于疾病缓解期的25岁胆管癌患者，在接受5个周期吉西他滨化疗后，出现微血管病性溶血性贫血伴急性无尿性肾衰竭，该病症符合该药不良反应诱发的溶血性尿毒症综合征表现。临床随即停用吉西他滨，并给予血液透析、输血、血浆置换、糖皮质激素、多西环素及利妥昔单抗进行治疗。患者最终获得良好转归，其中溶血性贫血得到有效控制，肾功能完全恢复正常。