Gemcitabine-Induced Hemolytic Uremic Syndrome: a Case Report

Extract

Hemolytic uremic syndrome (HUS) is a rare side effect of chemotherapeutic agents reported in patients treated with cisplatin and bleomycin ( 1 ) , mitomycin C ( 2 ) , and high-dose chemotherapy in general ( 3 ) . Gemcitabine is an effective drug for systemic therapy of non-smallcell lung cancer (NSCLC) ( 4 ) and has few, well-defined side effects ( 5 ) . One report ( 6 ) has been published about a mild HUS that appeared related to gemcitabine therapy. This report is to extend this observation in one patient who developed severe HUS in connection with the administration of gemcitabine therapy.

A 45-year-old Caucasian male was diagnosed with NSCLC (World Health Organization stage I, T2N0M0) of the right middle lobe in September 1994, and pneumonectomy was perfomed. Histology revealed free resection margins. In November 1996, the patient developed thoracic metastases. Subsequently, intravenous gemcitabine therapy (1250 mg/m ₂ on days 1, 8, and 15, administered over a 30-minute period, repeated every 28 days) was initiated. Antiemetic prophylaxis consisted of 3 mg granisetron given intravenously.