Skip to main content

Advertisement

SpringerLink
Log in

A rare case of acute kidney injury associated with autoimmune hemolytic anemia and thrombocytopenia after long-term usage of oxaliplatin

  • Case Report
  • Published:
Clinical and Experimental Nephrology Aims and scope Submit manuscript

Abstract

Oxaliplatin is effective in advanced colorectal cancer and is known to have relatively few side effects, such as hemolysis and renal toxicity. We report a case of acute kidney injury (AKI) after treatment with a combination of oxaliplatin, folinic acid and 5-fluorouracil or capecitabine. The patient developed acute renal failure, hemolytic anemia and thrombocytopenia after the 34th course of chemotherapy including oxaliplatin. A positive direct antiglobulin test and detection of immunoglobulin G and complement C3b and C3d on erythrocytes suggested the diagnosis of immune-related severe intravascular hemolytic anemia. She was successfully treated and recovered using plasma exchange, corticosteroids and hemodialysis therapy. Only seven other cases of AKI associated with oxaliplatin use have been reported to date. As in this case, acute hemolysis due to autoimmune mechanisms and subsequent AKI occurred suddenly after frequent use of oxaliplatin in four of those cases. We should be aware that oxaliplatin may cause sudden life-threatening hemolysis by drug-induced antibodies and subsequent AKI, even though oxaliplatin is frequently administered without side effects. This represents the first case report of AKI-related hemolysis due to oxaliplatin in Japan.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Maindrault-Goebel F, Louvet C, André T, Carola E, Lotz JP, Molitor JL, et al. Oxaliplatin added to the simplified bimonthly leucovorin and 5-fluorouracil regimen as second-line therapy for metastatic colorectal cancer (FOLFOX6). Eur J Cancer. 1999;35:1338–42.

    Google Scholar 

  2. Twelves C. Can capecitabine replace 5-FU/leucovorin in combination with oxaliplatin for the treatment of advanced colorectal cancer? Oncology. 2002;16:23–6.

    PubMed  Google Scholar 

  3. de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol. 2000;18:2938–47.

    PubMed  Google Scholar 

  4. Cassidy J, Misset JL. Oxaliplatin-related side effects: characteristics and management. Semin Oncol. 2002;29:11–20.

    Article  PubMed  CAS  Google Scholar 

  5. Lee HH, Hur H, Kim SH, Park AR, Kim W, Jeon HM. Outcomes of modified FOLFOX-6 as first line treatment in patients with advanced gastric cancer in a single institution; retrospective analysis. Cancer Res Treat. 2010;42:18–23.

    Article  PubMed  Google Scholar 

  6. Desrame J, Broustet H, de Darodes Tailly P, Girard D, Saissy JM. Oxaliplatin-induced haemolytic anaemia. Lancet. 1999;354:1179–80.

    Article  PubMed  CAS  Google Scholar 

  7. Pinotti G, Martinelli B. A case of acute tubular necrosis due to oxaliplatin. Ann Oncol. 2002;13:1951–2.

    Article  PubMed  CAS  Google Scholar 

  8. Hofheinz RD, Nguyen XD, Buchheidt D, Kerowgan M, Hehlmann R, Hochhaus A. Two potential mechanisms of oxaliplatin-induced haemolytic anaemia in a single patient. Cancer Chemother Pharmacol. 2004;53:276–7.

    Article  PubMed  Google Scholar 

  9. Labaye J, Sarret D, Duvic C, Herody M, Didelot F, Nedelec G, et al. Renal toxicity of oxaliplatin. Nephrol Dial Transplant. 2005;20:1275–6.

    Article  PubMed  CAS  Google Scholar 

  10. Dahabreh I, Tsoutsos G, Tseligas D, Janinis D. Hemolytic uremic syndrome following the infusion of oxaliplatin: case report. BMC Clin Pharmacol. 2006;6:5.

    Article  PubMed  Google Scholar 

  11. Buti S, Riccò M, Chiesa MD, Copercini B, Tomasello G, Brighenti M, et al. Oxaliplatin-induced hemolytic anemia during adjuvant treatment of a patient with colon cancer: a case report. Anticancer Drugs. 2007;18:297–300.

    Article  PubMed  CAS  Google Scholar 

  12. Ulusakarya A, Misra S, Haydar M, Habert H, Castagne V, Gumus Y, et al. Acute renal failure related to oxaliplatin-induced intravascular hemolysis. Med Oncol. 2010;27:1425–6.

    Article  PubMed  CAS  Google Scholar 

  13. Chaplin H Jr. Clinical usefulness of specific antiglobulin reagents in autoimmune hemolytic anemias. Prog Hematol. 1973;8:25.

    PubMed  Google Scholar 

  14. Fontão-Wendel R, Hoff PM, Lazar A, Freitas D, Novis Y, Patah P, et al. Immune-mediated pancytopenia induced by oxaliplatin: a case report. Transfusion. 2010;50:1453–9.

    Article  PubMed  Google Scholar 

  15. Makrilia N, Syrigou E, Kaklamanos I, Manolopoulos L, Saif MW. Hypersensitivity reactions associated with platinum antineoplastic agents: a systematic review. Met Based Drugs. 2010;2010:207084.

    Article  PubMed  Google Scholar 

  16. Markman M, Kennedy A, Webster K, Elson P, Peterson G, Kulp B, et al. Clinical features of hypersensitivity reactions to carboplatin. J Clin Oncol. 1999;17:1141–5.

    PubMed  CAS  Google Scholar 

  17. Chow KM, Lai FM, Wang AY, Chan YL, Tang NL, Li PK. Reversible renal failure in paroxysmal nocturnal hemoglobinuria. Am J Kidney Dis. 2001;37:E17.

    Article  PubMed  CAS  Google Scholar 

  18. Honda N, Hishida A. Pathophysiology of experimental nonoliguric acute renal failure. Kidney Int. 1993;43:513–21.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that no conflicts of interest exist.

Author information

Authors and Affiliations

  1. Department of Nephrology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Isao Ito, Yasuhiko Ito, Masashi Mizuno, Yasuhiro Suzuki, Kaoru Yasuda, Takenori Ozaki, Tomoki Kosugi, Yoshinari Yasuda, Waichi Sato, Naotake Tsuboi, Shoichi Maruyama, Enyu Imai & Seiichi Matsuo

  2. Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan

    Yasuhiko Ito, Masashi Mizuno & Yasuhiro Suzuki

  3. Department of CKD Initiatives, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan

    Yoshinari Yasuda

Authors
  1. Isao Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasuhiko Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masashi Mizuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yasuhiro Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kaoru Yasuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takenori Ozaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tomoki Kosugi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yoshinari Yasuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Waichi Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Naotake Tsuboi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shoichi Maruyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Enyu Imai
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Seiichi Matsuo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Isao Ito.

About this article

Cite this article

Ito, I., Ito, Y., Mizuno, M. et al. A rare case of acute kidney injury associated with autoimmune hemolytic anemia and thrombocytopenia after long-term usage of oxaliplatin. Clin Exp Nephrol 16, 490–494 (2012). https://doi.org/10.1007/s10157-012-0620-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10157-012-0620-8

Keywords

Search

Navigation