Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3392381 | Transplant Immunology | 2009 | 4 Pages |
Abstract
We report here a 50-years old female with multiple myeloma-associated chronic renal failure who underwent high-dose chemotherapy supported by autologous hematopoietic stem cell transplantation. She developed progressive encephalopathy on day 5 progressing to coma despite hemodialysis and no obvious organ failure. She finally recovered after a single 1-liter plasma exchange. The final diagnosis was metabolic encephalopathy due to hypercytokinemia, particularly high serum TNF levels. We discuss here the pathogenesis and raise an alert for monitoring cytokine levels in patients with renal failure undergoing high-dose chemotherapy.
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Authors
Daniele Focosi, Matteo Pelosini, Piero Palla, Sara Galimberti, Francesco Caracciolo, Edoardo Benedetti, Federico Papineschi, Mario Petrini,