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[Gemcitabine-induced thrombotic microangiopathy: Can we improve screening and treatment?]
- Source :
-
Nephrologie & therapeutique [Nephrol Ther] 2017 Jun; Vol. 13 (4), pp. 251-254. Date of Electronic Publication: 2017 May 09. - Publication Year :
- 2017
-
Abstract
- Thrombotic microangiopathy is a rare but severe complication of treatment with gemcitabine. Its prevalence increases because gemcitabine's indications are growing. We report four cases, which presented with common clinical and biological manifestations, i.e. high blood pressure, proteinuria and increasing plasmatic creatinine level. However, severity was not similar, hemodialysis was inconstant. There is no consensus on treatment for this condition. Stopping gemcitabine is essential. Treatment was dispensed considering the severity of the presentation: plasma exchange therapy of variable outcome, and eculizumab, which was efficient when used. It's important to note that this syndrome includes common and frequent signs in patients receiving chemotherapies. But they must encourage the research of most specific signs, such as hypertension, mechanic hemolysis signs, proteinuria or hematuria, in order to recognize thrombotic microangiopathy as early as possible to treat it precociously, and to prevent additional gemcitabine injections.<br /> (Copyright © 2017 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Adult
Antibodies, Monoclonal, Humanized therapeutic use
Deoxycytidine adverse effects
Female
Humans
Male
Middle Aged
Plasma Exchange
Severity of Illness Index
Thrombotic Microangiopathies diagnosis
Thrombotic Microangiopathies therapy
Gemcitabine
Antimetabolites, Antineoplastic adverse effects
Deoxycytidine analogs & derivatives
Thrombotic Microangiopathies chemically induced
Subjects
Details
- Language :
- French
- ISSN :
- 1872-9177
- Volume :
- 13
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Nephrologie & therapeutique
- Publication Type :
- Academic Journal
- Accession number :
- 28499586
- Full Text :
- https://doi.org/10.1016/j.nephro.2016.12.003