Abstract
Gemcitabine is a broad-spectrum anti-metabolite drug that is widely used in the therapy of numerous advanced cancers such as pancreatic, breast, ovary, lung, and bladder cancer. Gemcitabine has been reported to cause hemolytic uremic syndrome (HUS), but the underlying mechanism is not elucidated. The outcome of gemcitabine-induced HUS is often poor and associated with high mortality. We present a case report of a patient who was on chemotherapy for lung cancer and presented with the concerns of decreased urine output and shortness of breath. He was investigated and found to have HUS. He was managed with plasmapheresis, which resulted in partial recovery. This case report describes HUS caused by gemcitabine in patients with lung carcinoma and the management implemented and also aims to highlight the importance of early and timely recognition and treatment to improve clinical outcomes in these patients.
Highlights
Hemolytic uremic syndrome (HUS) is a principal subtype of thrombotic microangiopathic (TMA) syndromes that are characterized by common clinical and pathological features
We present a case report of a patient who was on chemotherapy for lung cancer and presented with the concerns of decreased urine output and shortness of breath
He was investigated and found to have hemolytic uremic syndrome (HUS). He was managed with plasmapheresis, which resulted in partial recovery. This case report describes HUS caused by gemcitabine in patients with lung carcinoma and the management implemented and aims to highlight the importance of early and timely recognition and treatment to improve clinical outcomes in these patients
Summary
Hemolytic uremic syndrome (HUS) is a principal subtype of thrombotic microangiopathic (TMA) syndromes that are characterized by common clinical and pathological features. A 65-year-old male presented to the hospital with chief concerns of swelling in the feet and a decreased urine output He was a known case of lung carcinoma and was being managed chemotherapy for five months. After completion of the fifth cycle, he noticed swelling in his feet, which gradually progressed and was associated with a decreased urine output He presented to the hospital when he developed shortness of breath. A thorough workup was performed to rule out tropical infections that are common causes of thrombocytopenia in developing countries like India, dengue, malaria, scrub typhus, and leptospira. His HIV serology and hepatitis B and C serology were negative. Physicians and caregivers are aiming to maintain the vital functioning of patients throughout the course of the disease
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