吉西他滨致溶血性尿毒症综合征

Hemolytic-uremic syndrome due to gemcitabine

1例25岁男性患者因上皮样血管内皮瘤接受吉西他滨1600mg(第1、8天)+多西他赛110mg(第8天)方案化疗,21d为1个周期。第3个化疗周期第1次静脉滴注吉西他滨后第7天,患者出现发热,未再继续化疗。第30天入住浙江医科大学附属第二医院拟行第4个周期化疗。入院第4天出现尿失禁,经导尿管引流出酱油色液体900ml,实验室检查示红细胞计数2.19×10^12/L、血红蛋白63g/L、血小板计数257×10^9/L,诊断为吉西他滨所致溶血性尿毒症综合征。经静脉滴注前列地尔注射液、注射用还原型谷胱甘肽和静脉输注悬浮红细胞等治疗6d后,患者一般情况较前好转。

A 25-year-old male patient with epithelioid hemangioendothelioma received periodic chemotherapy with gemcitabine 1 600 mg (on day 1 and 8 of each chemotherapy cycle) and docetaxel 110 mg (on day 8 of each chemotherapy cycle) and the chemotherapy cycle was 21 days. The patient developed fever on day 7 after the first IV infusion of gemcitabine in the third chemotherapy cycle and then the following infusions of this cycle was abandoned. Thirty days later, he was hospitalized in the Second Affiliated Hospital of Zhejiang University School of Medicine to undergo the fourth chemotherapy cycle. On day 4 after hospitalization, the patient developed urinary incontinence and 900 ml of soy sauce-colored liquid was drained by catheter. Laboratory tests showed red blood cell count 2.19×10^12/L, hemoglobin 63 g/L, and platelet 257×10^9/L. The patient was diagnosed as hemolytic-uremic syndrome due to gemcitabine. The patient′s condition improved after IV infusions of alprostadil injection, reduced glutathione for injection, and suspended red blood cells for 6 days.