Document Detail

A rare case of acute kidney injury associated with autoimmune hemolytic anemia and thrombocytopenia after long-term usage of oxaliplatin.
MedLine Citation:
PMID:  22450906     Owner:  NLM     Status:  MEDLINE    
Oxaliplatin is effective in advanced colorectal cancer and is known to have relatively few side effects, such as hemolysis and renal toxicity. We report a case of acute kidney injury (AKI) after treatment with a combination of oxaliplatin, folinic acid and 5-fluorouracil or capecitabine. The patient developed acute renal failure, hemolytic anemia and thrombocytopenia after the 34th course of chemotherapy including oxaliplatin. A positive direct antiglobulin test and detection of immunoglobulin G and complement C3b and C3d on erythrocytes suggested the diagnosis of immune-related severe intravascular hemolytic anemia. She was successfully treated and recovered using plasma exchange, corticosteroids and hemodialysis therapy. Only seven other cases of AKI associated with oxaliplatin use have been reported to date. As in this case, acute hemolysis due to autoimmune mechanisms and subsequent AKI occurred suddenly after frequent use of oxaliplatin in four of those cases. We should be aware that oxaliplatin may cause sudden life-threatening hemolysis by drug-induced antibodies and subsequent AKI, even though oxaliplatin is frequently administered without side effects. This represents the first case report of AKI-related hemolysis due to oxaliplatin in Japan.
Isao Ito; Yasuhiko Ito; Masashi Mizuno; Yasuhiro Suzuki; Kaoru Yasuda; Takenori Ozaki; Tomoki Kosugi; Yoshinari Yasuda; Waichi Sato; Naotake Tsuboi; Shoichi Maruyama; Enyu Imai; Seiichi Matsuo
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-03-27
Journal Detail:
Title:  Clinical and experimental nephrology     Volume:  16     ISSN:  1437-7799     ISO Abbreviation:  Clin. Exp. Nephrol.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-18     Completed Date:  2012-10-10     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  9709923     Medline TA:  Clin Exp Nephrol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  490-4     Citation Subset:  IM    
Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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MeSH Terms
Acute Kidney Injury / drug therapy,  etiology*
Anemia, Hemolytic, Autoimmune / chemically induced*
Antineoplastic Combined Chemotherapy Protocols / adverse effects*
Colonic Neoplasms / drug therapy
Deoxycytidine / adverse effects,  analogs & derivatives
Fluorouracil / adverse effects,  analogs & derivatives
Leucovorin / adverse effects
Middle Aged
Organoplatinum Compounds / adverse effects*
Prednisone / therapeutic use
Thrombocytopenia / chemically induced
Reg. No./Substance:
0/Organoplatinum Compounds; 51-21-8/Fluorouracil; 53-03-2/Prednisone; 58-05-9/Leucovorin; 63121-00-6/oxaliplatin; 6804DJ8Z9U/capecitabine; 951-77-9/Deoxycytidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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