Mitomycin-C induced hemolytic uremic syndrome: a case report and literature review |
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Authors: | Wu DC; Liu JM; Chen YM; Yang S; Liu SM; Chen LT; Whang-Peng J |
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Institution: | Department of Internal Medicine, Veterans' General Hospital-Taipei, Taiwan, Republic of China. |
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Abstract: | Hemolytic uremic syndrome spontaneously arises in a few patients with
advanced cancer, but it is more commonly related to the use of certain
chemotherapeutic agents. Mitomycin-C is, etiologically, the most common
causative agent inducing hemolytic uremic syndrome, in a dose dependent
manner. We report this syndrome, attributable to mitomycin-C at a
cumulative dose of 40 mg/m2, in a gastric cancer patient. A 42-year-old
female with stage III gastric cancer underwent radical gastrectomy and was
given mitomycin-C at 10 mg/m2 intravenously every four weeks as adjuvant
therapy. Hemolytic uremic syndrome was diagnosed three months after the
last dose of mitomycin-C administration. The most prominent symptoms
included pallor, hypertension and anasarca, with laboratory evidence of
microangiopathic hemolytic anemia, azotemia and hyperkalemia. Her disease
was progressive, but fortunately stabilized after staphylococcus column A
dialysis. Her disease remained in remission for 24 months from the time of
diagnosis, and then relapsed in the form of peritoneal carcinomatosis with
partial intestinal obstruction.
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