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KMID : 0366219880230010221
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Korean Journal of Hematology
1988 Volume.23 No. 1 p.221 ~ p.227
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Mitomycin-C Induced Hemolytic-Uremic Syndrome
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정영란/Young Ran Jeong
이병기/김시영/윤휘중/조경삼/지현숙/Byung Ki Lee/Si Young Kim/Hwi Joong Yoon/Kyung Sam Cho/Hyun Sook Chi
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Abstract
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Hemolytic-uremic syndrome (microangiopathic hemolytic anemia, thrombocytopenia,
and renal insufficiency) may be induced 1 to 2 month after administration of mitomycin-
C, and it develops usually in clinical remission state of cancer. The mechanism of this
syndrome is unknown and effect of therapy is controversial. We report a case of
hemolytic-uremic syndrome developed after chemotherapy of gastric cancer.
A 31 year old housewife was diagnosed as adenocarcinoma of stomach by
gastroscopic biopsy. Laparotomy revealed ovarian metastasis of cancer and gastrectomy
was not done. FAM chemotherapy was done for 6 months thereafter, with total
mitomycin-C dose of 60㎎. Chemotherapy was discontinued because of anemia and
thrombocytopenia and patient received packed RBC transfusion without improvement.
She was admitted 2 months after last dose of chemotherapy because of bowel
obstruction. The serum creatinine level was elevated and peripheral blood exam revealed
microangiopathic hemolytic anemia. Laparotomy revealed adhesion of bowel, but there
was no grossly visible tumor in the abdomen except one small nodule of omentum,
which was confirmed as metastic adeno carcinoma. She was treated with corticosteroid
and plasmapheresis 6 times without improvement. She discharged for home care.
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