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  1. 掲載誌一覧
  2. 鹿児島大学医学雑誌
  3. vol.67(1-3)
  1. 医歯学総合研究科
  2. 鹿児島大学医学会
  3. 鹿児島大学医学雑誌

Mechanical Circulatory Support as a Potentially Useful Strategy in Patients with Severe Cyclophosphamide-induced Cardiotoxicity

http://hdl.handle.net/10232/00030363
http://hdl.handle.net/10232/00030363
3f360726-1b3f-48a6-90e9-5a790161cb6c
名前 / ファイル ライセンス アクション
AN00040104_67_p41-50.pdf AN00040104_67_p41-50 (1.8 MB)
Item type 紀要論文 / Departmental Bulletin Paper(1)
公開日 2018-12-06
タイトル
タイトル Mechanical Circulatory Support as a Potentially Useful Strategy in Patients with Severe Cyclophosphamide-induced Cardiotoxicity
別言語のタイトル
その他のタイトル シクロフォスファミドに伴う重症心筋障害を合併した患者に対する補助循環装置の有用性について
著者 NAKAE, Koji

× NAKAE, Koji

WEKO 132296

NAKAE, Koji

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UENO, Kentaro

× UENO, Kentaro

WEKO 132297

UENO, Kentaro

Search repository
KAWAMURA, Junpei

× KAWAMURA, Junpei

WEKO 132298

KAWAMURA, Junpei

Search repository
YANAGIMOTO, Kosuke

× YANAGIMOTO, Kosuke

WEKO 132299

YANAGIMOTO, Kosuke

Search repository
EGUCHI, Taisuke

× EGUCHI, Taisuke

WEKO 132300

EGUCHI, Taisuke

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NOMURA, Yuichi

× NOMURA, Yuichi

WEKO 132301

NOMURA, Yuichi

Search repository
KAKIHANA, Yasuyuki

× KAKIHANA, Yasuyuki

WEKO 132302

KAKIHANA, Yasuyuki

Search repository
KAWANO, Yoshifumi

× KAWANO, Yoshifumi

WEKO 132303

KAWANO, Yoshifumi

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別言語の著者
姓名 中江, 広治
別言語の著者
姓名 上野, 健太郎
別言語の著者
姓名 川村, 順平
別言語の著者
姓名 柳元, 孝介
別言語の著者
姓名 江口, 太助
別言語の著者
姓名 野村, 裕一
別言語の著者
姓名 垣花, 泰之
別言語の著者
姓名 河野, 嘉文
言語
言語 eng
キーワード
主題言語 en
主題Scheme Other
主題 cyclophosphamide
キーワード
主題言語 en
主題Scheme Other
主題 bone marrow transplantation (BMT)
キーワード
主題言語 en
主題Scheme Other
主題 cardiotoxicity
キーワード
主題言語 en
主題Scheme Other
主題 percutaneous cardiopulmonary support (PCPS)
キーワード
主題言語 en
主題Scheme Other
主題 intra-aortic balloon pump (IABP)
資源タイプ
資源タイプ識別子 http://purl.org/coar/resource_type/c_6501
資源タイプ departmental bulletin paper
要約(Abstract)
内容記述タイプ Other
内容記述 Cyclophosphamide is one of the most widely used antineoplastic drugs. It is also a potent immunosuppressive agent administered to patients undergoing bone marrow transplantation (BMT). Here we report two cases of aplastic anemia in which severe cardiac dysfunction followed the serial administration of cyclophosphamide (50 mg/m² for 4 days). Both patients gradually developed dyspnea and showed oliguria 3–4 days after BMT. Cardiomegaly was seen on chest X-ray. Echocardiography showed reduced left ventricular contraction, pericardial effusion, and myocardial thickening. Cyclophosphamide-induced cardiotoxicity was suspected and the patients were treated accordingly but were refractory to pharmacotherapy. They were transferred to the intensive care unit where they received mechanical cardiopulmonary support, which improved left ventricular cardiac performance and led to a regression of myocardial thickening. Although both patients died because of severe pulmonary and renal complications, the rapid initiation of mechanical cardiopulmonary support may be a useful strategy in patients with a deteriorating condition, by allowing cardiac recuperation and therefore gaining time for further, potentially life-saving treatment.
要約(Abstract)
内容記述タイプ Other
内容記述 シクロフォスファミドは抗腫瘍薬として、また骨髄移植の前処置時に免疫抑制薬としても広く使用されている。われわれは、シクロフォスファミド投与後(50mg/m2 4 日間)に重症心筋障害をきたした再生不良性貧血の2 症例を経験した。両患者ともに移植後3-4 日で呼吸困難、乏尿がみられ、胸部エックス線で心拡大、心エコー検査で左室収縮能の低下、心嚢液貯留および心筋肥厚所見を認めた。シクロフォスファミドによる重症心筋障害から循環不全をきたしたと考え、循環作動薬で加療したが改善せず、集中治療室で経皮的心肺補助装置、大動脈内バルーンパンピングを用いた補助循環装置を導入した。補助循環装置での治療開始後、心収縮力は改善し、心筋肥厚も軽快した。両患者ともに補助循環装置から離脱することができたが、重篤な移植後合併症で死亡した。シクロフォスファミドによる重症心筋障害はまれに発生するが、早期の診断ならびに補助循環装置を用いた集中治療管理を行うことで心筋の回復が得られ、予後の改善に繋がる可能性がある。
収録雑誌名 鹿児島大学医学雑誌
en : Medical journal of Kagoshima University

巻 67, 号 1-3, p. 41-50, 発行日 2015-12
作成日
日付 2015-12
ISSN
収録物識別子タイプ ISSN
ISSN 03685063
NII書誌ID(雑誌)
収録物識別子タイプ NCID
NC ID AN00040104
出版タイプ
出版タイプ VoR
出版タイプResource http://purl.org/coar/version/c_970fb48d4fbd8a85
NDC
主題Scheme NDC
主題 493
公開者・出版者
出版者 鹿児島大学
公開者よみ
公開者よみ カゴシマ ダイガク
公開者別名
公開者別名 Kagoshima University
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