Gemcitabine-induced thrombotic microangiopathy: Can we improve screening and treatment? - Archive ouverte HAL
Article Dans Une Revue Néphrologie & Thérapeutique Année : 2017

Gemcitabine-induced thrombotic microangiopathy: Can we improve screening and treatment?

X. Charmetant
A. Jolivot
  • Fonction : Auteur
T. Fournier
  • Fonction : Auteur
J. C. Puthet
  • Fonction : Auteur
Pierre Cassier
  • Fonction : Auteur
S. Lemoine
  • Fonction : Auteur

Résumé

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. (C) 2017 Societe francophone de nephrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.
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Dates et versions

hal-01848151 , version 1 (24-07-2018)

Identifiants

Citer

X. Charmetant, A. Jolivot, T. Fournier, J. C. Puthet, Pierre Cassier, et al.. Gemcitabine-induced thrombotic microangiopathy: Can we improve screening and treatment?. Néphrologie & Thérapeutique, 2017, 13 (4), pp.251-254. ⟨10.1016/j.nephro.2016.12.003⟩. ⟨hal-01848151⟩
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