Blood purification · 2014
High cutoff membrane to reduce systemic inflammation due to differentiation syndrome: a case report.
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Villa Gianluca, Zaragoza Jose J, Sharma Aashish, Chelazzi Cosimo, Ronco Claudio, De Gaudio A Raffaele
Аннотация
BACKGROUND: Differentiation syndrome is a life-threatening complication of therapy that is carried out with agents used for acute promyelocytic leukemia. Its physiopathology comprehends the production of inflammatory mediators by differentiating granulocytes, endothelial and alveolar cells due to stimulation by all-trans retinoic acid and leading to sustained systemic inflammation.
METHODS: Treatment with high cut-off continuous veno-venous hemodialysis (HCO-CVVHD) was performed to reduce the circulating mediators of systemic inflammation.
RESULTS: After 52 h of treatment, an important reduction was observed in inflammatory mediators (IL-1β: from 10 to 2 pg/ml; IL-8: from 57 to 40 pg/ml; TNF-α: from 200 to 105 pg/ml; IL-6: from 263 to 91 pg/ml), as well as in anti-inflammatory mediators (IL-10: from 349 to 216 pg/ml).
CONCLUSIONS: HCO-CVVHD should be explored as a part of treatment in systemic inflammation states other than sepsis (e.g., differentiation syndrome). Furthermore, its immunomodulatory effects could be particularly useful in immunocompromised patient treated with corticosteroids.
METHODS: Treatment with high cut-off continuous veno-venous hemodialysis (HCO-CVVHD) was performed to reduce the circulating mediators of systemic inflammation.
RESULTS: After 52 h of treatment, an important reduction was observed in inflammatory mediators (IL-1β: from 10 to 2 pg/ml; IL-8: from 57 to 40 pg/ml; TNF-α: from 200 to 105 pg/ml; IL-6: from 263 to 91 pg/ml), as well as in anti-inflammatory mediators (IL-10: from 349 to 216 pg/ml).
CONCLUSIONS: HCO-CVVHD should be explored as a part of treatment in systemic inflammation states other than sepsis (e.g., differentiation syndrome). Furthermore, its immunomodulatory effects could be particularly useful in immunocompromised patient treated with corticosteroids.
Предметные рубрики MeSH
Acute Kidney InjuryAdultAnticoagulantsAntineoplastic Combined Chemotherapy ProtocolsCalcium CitrateCapillary Leak SyndromeCell DifferentiationDisseminated Intravascular CoagulationFatal OutcomeHemofiltrationHumansIdarubicinImmunomodulationInflammationInflammation MediatorsLeukemia, Promyelocytic, AcuteMaleMembranes, ArtificialMolecular WeightPermeabilityPrednisoloneRespiratory InsufficiencySerum AlbuminSyndromeTretinoin