Haemolytic Uraemic Syndrome Associated with Docetaxel: A Case Report

Abstract

Haemolytic uraemic syndrome (HUS) has no recognised association with single-agent docetaxel. We present the first documented case of HUS associated with docetaxel in a patient receiving adjuvant chemotherapy for early breast cancer. A previously fit 49-year-old presented nineteen days post final cycle of docetaxel (100 mg/m2 ) with general malaise, epistaxis and decreased urine output. Baseline bloods revealed haemoglobin (53 g/L), urea (45.2 mmol/L), creatinine (1706 µmol/L) and LDH (2140 IU/L). Tumor lysis syndrome was excluded on further biochemical analysis. Blood film analysis demonstrated evidence of acanthocytes, anisocytosis and red cell fragments. Septic, viral and autoimmune screens were negative. There was clear evidence of microangiopathic haemolysis alongside renal dysfunction. She required dialysis, plasma exchanges and blood transfusions. Renal function and blood counts normalised within two months post-admission due to prompt and aggressive management. HUS should be considered in any patient receiving docetaxel who develops simultaneous acute kidney injury and severe anemia.