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Zerebrale Vaskulitis unter Gemcitabin

Cerebral vasculitis associated with gemcitabine

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Zusammenfassung

Wir berichten über eine 50-jährige Patientin mit einem Urothelkarzinom pT4acN0cM0 der Harnblase, bei der nach problemloser Applikation des 1. Zyklus einer neoadjuvant intentionierten Chemotherapie mit Gemcitabin und Cisplatin im 2. Zyklus generalisierte Krampfanfälle und ein ausgeprägtes hirnorganisches Psychosyndrom auftraten. In der MRT des Kopfes fand sich das Bild einer zerebralen Vaskulitis. Der enge zeitliche Zusammenhang zwischen der Gemcitabin-Gabe und dem Auftreten der Krampfanfälle legt einen kausalen Zusammenhang nahe. Während in jüngerer Zeit wiederholt Vaskulitiden in anderen Gefäßgebieten und Leukenzephalopathien beschrieben wurden, ist dies der erste Fall einer Gemcitabin-induzierten zerebralen Vaskulitis.

Abstract

Neoadjuvant chemotherapy consisting of cisplatin and gemcitabine was given to a 50-year-old woman suffering from transitional cell carcinoma of the bladder. Whereas the first cycle was administered without major side effects, the patient experienced a generalized tonic–clonic seizure and a prolonged cognitive deficit with the second cycle. Magnetic resonance imaging of the brain was consistent with cerebral vasculitis. The short interval between the application of gemcitabine and the neurological deterioration suggests a causal relationship. Although recent reports have linked this drug with leukoencephalopathy and vasculitis in various localizations, this is the first case of cerebral vasculitis associated with gemcitabine.

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Authors and Affiliations

  1. Urologische Klinik, Diakoniekrankenhaus Friederikenstift gGmbH, Humboldtstraße 5, 30169, Hannover, Deutschland

    P. Schmorl & S. Conrad

  2. Abteilung für Hämatologie und Onkologie, Zentrum für Innere Medizin, Diakoniekrankenhaus Friederikenstift gGmbH, Hannover, Deutschland

    A. Heer-Sonderhoff

  3. MRT im Friederikenstift, Hannover, Deutschland

    R. Vosshenrich

Authors
  1. P. Schmorl
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  2. A. Heer-Sonderhoff
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  3. R. Vosshenrich
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  4. S. Conrad
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Correspondence to P. Schmorl.

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Schmorl, P., Heer-Sonderhoff, A., Vosshenrich, R. et al. Zerebrale Vaskulitis unter Gemcitabin. Urologe 49, 268–270 (2010). https://doi.org/10.1007/s00120-009-2203-1

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  • DOI: https://doi.org/10.1007/s00120-009-2203-1

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