• Yu Nishijima, Haruhiko Hirata, Aiko Himeno, Hiroshi Kida, Masanori Matsumoto, Ryo Takahashi, Yasushi Otani, Kouji Inoue, Izumi Nagatomo, Yoshito Takeda, Takashi Kijima, Isao Tachibana, Yoshihiro Fujimura, and Atsushi Kumanogoh.
• Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan.
• Intern. Med. 2013 Jan 1; 52 (10): 111111141111-4.

AbstractA 61-year-old woman with recurrent non-small cell lung cancer presented with thrombocytopenia, microangiopathic hemolytic anemia, neurological abnormalities, renal failure and a fever that appeared during chemotherapy with gemcitabine and bevacizumab. She was diagnosed with drug-induced thrombotic thrombocytopenic purpura (TTP). After the discontinuation of chemotherapy, the administration of recombinant human soluble thrombomodulin and fresh-frozen plasma rapidly ameliorated the TTP. Hypertension preceded the onset of TTP and required the administration of quadruple therapy on admission. However, after three months, the hypertension was controllable without anti-hypertensive drugs. Twelve months later, the ninth course of vinorelbine was administered safely, preventing the patient's lung cancer from progressing.

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