Complement C5 inhibition reverses bleomycin-induced thrombotic microangiopathy.
bleomycin
complement
eculizumab
lung fibrosis
thrombotic microangiopathy
Journal
Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
27
04
2020
entrez:
12
4
2021
pubmed:
13
4
2021
medline:
13
4
2021
Statut:
epublish
Résumé
Whether C5 blocking may improve the outcomes of patients developing chemotherapy-induced thrombotic microangiopathy (TMA) remains elusive. Lung fibrosis is a well-known complication of bleomycin, whereas TMAs are very rare (<20 cases described). Here, we report an exceptional case of a male patient that developed acute respiratory distress syndrome and TMA following administration of bleomycin, cisplatin and etoposide . Refractoriness to plasma exchanges prompted us to use eculizumab as salvage therapy. Eculizumab led to complete remission of the TMA before Day 2. However, the patient progressed towards refractory respiratory failure, suggesting that pathophysiological mechanisms of bleomycin-induced lung fibrosis and TMA differ.
Identifiants
pubmed: 33841872
doi: 10.1093/ckj/sfaa101
pii: sfaa101
pmc: PMC8023184
doi:
Types de publication
Case Reports
Langues
eng
Pagination
1275-1276Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.
Références
Lancet. 2017 Aug 12;390(10095):681-696
pubmed: 28242109
Br J Clin Pharmacol. 2019 Feb;85(2):403-412
pubmed: 30394581
Clin Kidney J. 2013 Oct;6(5):484-5
pubmed: 26120441
FASEB J. 2016 Jun;30(6):2336-50
pubmed: 26956419
Ann Intern Med. 1986 Jul;105(1):48-51
pubmed: 2424354