Sunitinib 투여로 유발된 혈전성 혈소판 감소성 자반증 1예
A Case of Sunitinib-Associated Thrombotic Thrombocytopenic Purpura
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
혈전성 혈소판 감소성 자반증 및 용혈성 요독성 증후군은 다발성 장기 손상 및 미세혈관병증 용혈빈혈을 보이는 급성 질환으로 치료하지 않을 경우 환자의 생명을 위협하는 치명적인 질환이다. 최근 VEGFR-TKI가 혈전성 혈소판 감소성 자반증을 유발할 수 있다는 보고가 나오고 있어, 저자들은 전이성 콩팥세포암종 환자에서 수니티닙을 사용한 뒤, 혈전성 혈소판 감소성 자반증이 발생한 1예를 경험하였기에 이를 보고하는 바이다.
Abstract
Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome (TTP-HUS) is an acute condition with abnormalities of multiple organ systems. It is characterized by microangiopathic hemolytic anemia and thrombocytopenia. Several chemotherapeutic agents have been implicated in causing TTP-HUS. We report a case of TTP-HUS during treatment with sunitinib in a patient with metastatic renal cell carcinoma. A 53-year-old woman visited our hospital for fever and cough. She was diagnosed with sunitinib-induced TTP. Discontinuation of sunitinib and plasmapheresis improved her TTP. When she experienced disease progression after a prolonged period without treatment, sorafenib was tried, resulting in a partial response without recurrence of TTP-HUS.
참고문헌 (10)
- Terrell DR, "The incidence of thrombotic thrombocytopenic purpura-emolytic uremic syndrome: all patients, idiopathic patients, and patients with severe ADAMTS-3 deficiency", J Thromb Haemost, 3, pp.1432~1436 (2005)
- Medina PJ, "Drug-ssociated thrombotic thrombocytopenic purpura-emolytic uremic syndrome", Curr Opin Hematol, 8, pp.286~293 (2001)
- Talebi TN, "Sunitinib-induced microangiopathic hemolytic anemia with fatal outcome", Am J Ther, 19, pp.143~145 (2012)
- Kapiteijn E, "Sunitinib induced hypertension, thrombotic microangiopathy and reversible posterior leukencephalopathy syndrome", Ann Oncol, 18, pp.1745~1747 (2007)
- Papaetis GS, "Sunitinib : a multitargeted receptor tyrosine kinase inhibitor in the era of molecular cancer therapies", BioDrugs, 23, pp.377~389 (2009)
- Frangié C, "Renal thrombotic microangiopathy caused by anti-EGF-ntibody treatment for metastatic renal-ell carcinoma", Lancet Oncol, 8, pp.177~178 (2007)
- 최문기, "TTP-HUS Associated with Sunitinib", Cancer Research and Treatment, 40(4), pp.211~213 (2008), 대한암학회
- Nzerue CM, "Thrombotic microangiopathies", N Engl J Med, 347, pp.2171~2173 (2002)
- Franchini M, "Reduced von Willebrand factor-leaving protease levels in secondary thrombotic microangiopathies and other diseases", Semin Thromb Hemost, 33, pp.787~797 (2007)
- Eremina V, "VEGF inhibition and renal thrombotic microangiopathy", N Engl J Med, 358, pp.1129~1136 (2008)