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Pharmacogenetic analysis of irreversible severe cisplatin-induced nephropathy: a case report of a 27-year-old woman.

ABSTRACT: In this report we describe a young patient diagnosed with bulky FIGO stage IIIb squamous cell cervix carcinoma with severe and irreversible nephropathy after three weekly low-doses of cisplatin. Besides several known risk factors such as hypomagnesemia and hypoalbuminemia, the patient also proved to be homozygously polymorphic for two polymorphisms within the COMT gene (c.615 + 310C>T and c.616-367C>T). As COMT polymorphism has been associated with cisplatin-induced ototoxicity, its effect on nephrotoxicity of cisplatin should be the subject of further investigation.

SUBMITTER: de Jong C

PROVIDER: S-EPMC5555872 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Pharmacogenetic analysis of irreversible severe cisplatin-induced nephropathy: a case report of a 27-year-old woman.

de Jong Corine C Sanders Stefan S Creemers Geert-Jan GJ Burylo Artur M AM Taks Margot M Schellens Jan H M JHM Deenen Maarten J MJ

British journal of clinical pharmacology 20170531 9

In this report we describe a young patient diagnosed with bulky FIGO stage IIIb squamous cell cervix carcinoma with severe and irreversible nephropathy after three weekly low-doses of cisplatin. Besides several known risk factors such as hypomagnesemia and hypoalbuminemia, the patient also proved to be homozygously polymorphic for two polymorphisms within the COMT gene (c.615 + 310C>T and c.616-367C>T). As COMT polymorphism has been associated with cisplatin-induced ototoxicity, its effect on ne ...[more]

PMID: 28560854

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Project description:BackgroundImmune thrombocytopenia (ITP) is a rare autoimmune disorder characterized by low platelet counts and increased bleeding risk. The disease may be induced by other disorders, including malignancies, autoimmune diseases, infectious agents or drugs. However, ITP has also been described following vaccinations, such as the measles-mumps-rubella vaccination. In rare cases, ITP may occur in children who received a DTaP-IP (diphtheria, tetanus, acellular pertussis vaccine and inactivated poliovirus) vaccine. Hereinafter, we report the first well-documented cases of ITP in an adult patient in the temporal context of a DTaP-IP vaccination.Case presentationThis case report attempts to capture the life-threatening picture of a 36-year-old otherwise healthy Caucasian woman with newly diagnosed severe immune thrombocytopenia in the temporal context of a DTaP-IP vaccination. Four days after receiving the vaccine, the women presented to her primary care physician with malaise, fever and recurrent epistaxis. Clinical examination revealed oral petechiae, ecchymoses, and non-palpable petechiae on both legs. The patient was immediately referred to a local hematology unit where she developed hematuria and an intestinal bleeding (WHO Bleeding Grade III) requiring multiple transfusions. After receiving oral corticosteroids and intravenous immunoglobulins, her platelets gradually recovered. Common causes of secondary ITP were ruled out by laboratory investigations, bone marrow and peripheral blood examinations. This raises the possibility of a (secondary) vaccination-associated thrombocytopenia. To the best of our knowledge, this is the first well-documented case of a DTaP-IP vaccination-related ITP in an adult patient in the English literature.ConclusionAlthough a causal connection between both entities may not be established, we would like to raise awareness in clinicians that ITP following DTaP-IP vaccinations is potentially not limited to children, but may also occur in adults. Users of DTaP-IP booster vaccines should be alert of the possibility of such adverse reactions.

Dataset Information

Pharmacogenetic analysis of irreversible severe cisplatin-induced nephropathy: a case report of a 27-year-old woman.

Publications

Pharmacogenetic analysis of irreversible severe cisplatin-induced nephropathy: a case report of a 27-year-old woman.

Similar Datasets

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