[A case of pulmonary adenocarcinoma accompanied by minimal change nephrotic syndrome, antiphospholipid syndrome and warm-type autoimmune hemolytic anemia]

Nihon Kokyuki Gakkai Zasshi. 2006 Sep;44(9):631-5.
[Article in Japanese]

Abstract

A 49-year-old man was urgently admitted due to edema in both leg and left toe pain. A chest radiograph revealed a solitary nodule in the right lung field. Detailed investigations including bronchoscopy and renal biopsy led to a simultaneous diagnosis of clinical stage IIIB pulmonary adenocarcinoma, minimal change nephrotic syndrome, antiphospholipid syndrome, and warm-type autoimmune hemolytic anemia. Prednisolone was administered for nephrotic syndrome, antiphospholipid syndrome and warm-type autoimmune hemolytic anemia, and 6 courses of chemotherapy with 70Gy radio-therapy were performed. The pulmonary nodule significantly decreased in size and the other three autoimmune diseases appeared to be well-controlled. Thirteen months after admission, multiple brain metastases developed along with worsening antiphospholipid syndrome symptoms including lupus anticoagulant. Following whole-brain irradiation, the brain metastases decreased in size and antiphospholipid syndrome symptoms improved. Thirty-nine months after the initial visit, the primary lung cancer, its brain metastasis and the 3 other autoimmune diseases appeared to be well-controlled. The temporal correlation of the lung cancer and the three autoimmune diseases suggests the latter may be paraneoplastic syndrome.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adenocarcinoma / complications*
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / secondary
  • Anemia, Hemolytic, Autoimmune / drug therapy
  • Anemia, Hemolytic, Autoimmune / etiology*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Antiphospholipid Syndrome / drug therapy
  • Antiphospholipid Syndrome / etiology*
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / secondary
  • Carboplatin / administration & dosage
  • Cranial Irradiation
  • Drug Administration Schedule
  • Humans
  • Lung Neoplasms / complications*
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Nephrosis, Lipoid / drug therapy
  • Nephrosis, Lipoid / etiology*
  • Paclitaxel / administration & dosage
  • Prednisolone / administration & dosage

Substances

  • Prednisolone
  • Carboplatin
  • Paclitaxel