Drug-induced thrombotic microangiopathy after adjuvant chemotherapy in malignant ovarian germ cell tumor: A case report and literature review

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2024-10-29 DOI:10.1016/j.tjog.2024.03.025

Kuang-Yen Lee , Szu-Yu Pan , Thomas Tao-Min Huang , Wei-Chou Lin , Ying-Cheng Chiang

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引用次数: 0

Abstract

Objective

We presented a rare case of drug-induced thrombotic microangiopathy (DI-TMA) following chemotherapy with the regimen of bleomycin, etoposide, and cisplatin (BEP) in a patient with malignant ovarian germ cell tumor (MOGCT). The objective is to highlight the difficulty in diagnosing and treating DI-TMA associated with BEP chemotherapy.

Case report

A 21-year-old woman presented with a pelvic mass. Fertility-sparing staging surgery was performed, and a diagnosis of endodermal sinus tumor was confirmed. The patient received the first course of adjuvant chemotherapy with BEP regimen, but she developed symptoms of anemia, thrombocytopenia, and acute kidney injury. DI-TMA was diagnosed after thorough examinations, and she improved gradually by three courses of plasma exchange. Adjuvant chemotherapy was discontinued due to DI-TMA, and she kept disease-free for 17 months after the operation.

Conclusion

DI-TMA, a rare lethal complication in MOGCT patients receiving the BEP regimen, requires prompt diagnosis and appropriate treatments.

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恶性卵巢生殖细胞瘤辅助化疗后药物诱发的血栓性微血管病：病例报告和文献综述

目的我们介绍了一例罕见的恶性卵巢生殖细胞瘤（MOGCT）患者在接受博莱霉素、依托泊苷和顺铂（BEP）化疗后发生药物诱发血栓性微血管病（DI-TMA）的病例。病例报告一名 21 岁女性因盆腔肿块就诊。病例报告：一名 21 岁女性因盆腔肿块就诊，接受了保胎分期手术，确诊为内胚窦肿瘤。患者接受了第一个疗程的 BEP 方案辅助化疗，但出现了贫血、血小板减少和急性肾损伤症状。经过全面检查，她被确诊为 DI-TMA，经过三个疗程的血浆置换，她的病情逐渐好转。结论DI-TMA 是接受 BEP 方案治疗的 MOGCT 患者中罕见的致命并发症，需要及时诊断和适当治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.