Mitomycin C-induced Renal Insufficiency: A Case Report

Mitomycin C引起之腎功能不全－病例報告

文美卿(Mei-Chin Wen) ； 陳呈旭(Cheng-Hsu Chen) ； 何霖(William L. Ho)

《The Kaohsiung Journal of Medical Sciences》 19卷6期 (2003/06) Pp. 317-321

摘要

本文描述一位58歲正常血壓及腎功能的男性胃癌患者，在接受全胃切除後，使用輔助性化學療法－mitomycin C(MMC)治療，療程10個月。在治療開始9個月後，發現有貧血、高血壓及腎功能不全，腎臟切片檢查顯示有栓塞性微血管病變，嚴重的腎絲球間質溶解，血管內皮細胞下間隙擴張及腎小管細胞的細胞異常。患者腎功能一度一直惡化，最後在交換血漿、嚴格控制血壓及抗血小板藥物的治療下，使患者腎功能穩定下來。在追蹤3年後未有腫瘤復發。我們建議所有接受MMC治療的患者，都應該被密切的追蹤血壓及腎功能，以防止藥物造成的腎功能不全。

關鍵字

栓塞性微血管病變 ； 腎絲球間質溶解

並列摘要

A 58-year-old normotensive male with normal renal function and gastric cancer underwent total gastrectomy and received adjuvant chemotherapy with mitomycin C (MMC) for 10 months. He developed anemia, hypertension, and renal function impairment 9 months after initiation of chemotherapy. Kidney biopsy showed thrombotic micro angiopathy with marked mesangiolysis and expansion of the subendothelial space resulting in cystic dilation of the glomerular capillaries, and cellular atypia in the tubular cells. His renal function deteriorated gradually then stabilized after treatment with plasma exchange, antihypertensive agents, and antiplatelet agents. He had no sign of tumor recurrence after 3 years of follow-up. We suggest that patients receiving MMC should have their blood pressure and renal function closely monitored for the possibility of development of drug-induced renal insufficiency.

並列關鍵字

mitomycin C ； thrombotic microangiopathy ； mesangiolysis ； hemolytic-uremic syndrome ； nephrotoxicity