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首页> 外文期刊>Cancer and Clinical Oncology >An Unusual Case of a Hemolytic Crisis associated with the Initiation of an Aromatase Inhibitor in a Patient with Known History of Paroxysmal Nocturnal Hemoglobinuria
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An Unusual Case of a Hemolytic Crisis associated with the Initiation of an Aromatase Inhibitor in a Patient with Known History of Paroxysmal Nocturnal Hemoglobinuria

机译：在发作性夜间血红蛋白尿病史已知的患者中，与引发芳香酶抑制剂相关的溶血性疾病的罕见病例

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Paroxysmal Nocturnal Hemoglobinuria (PNH) is a rare hemolytic disorder characterized by partial or complete absence of the glycosylphosphatidylinositol-anchored proteins (GPI-AP) on the cell membrane of erythrocytes, platelets, and granulocytes rendering them vulnerable to destruction by the complement system. Various medications can provoke hemolytic crises in PNH or healthy subjects. Aromatase inhibitors (AI), which have revolutionized breast cancer management, are not known to trigger hemolytic crises. We report on a case of a 70-year-old female with PNH who was also diagnosed with breast cancer. Following lumpectomy and adjuvant radiation therapy, she was started on an AI to decrease risk of breast cancer recurrence. A few weeks later, she developed malaise, insomnia, and gross hematuria. Diagnostic workup including flow cytometry revealed a hemolytic crisis related to her PNH. An exhaustive investigation to uncover a potential mechanism that may explain the relation between AI initiation and onset of hemolytic crisis was unrevealing.
机译：阵发性夜间血红蛋白尿（PNH）是一种罕见的溶血性疾病，其特征是红细胞，血小板和粒细胞的细胞膜上部分或完全不存在糖基磷脂酰肌醇固定的蛋白（GPI-AP），使其容易被补体系统破坏。各种药物可在PNH或健康受试者中引发溶血性疾病。芳香酶抑制剂（AI）已彻底改变了乳腺癌的治疗方法，尚不引发溶血性危机。我们报道了一例70岁的PNH女性患者，她也被诊断出患有乳腺癌。进行了肿块切除术和辅助放疗后，她开始接受AI治疗，以降低乳腺癌复发的风险。几周后，她出现全身乏力，失眠和严重血尿。诊断检查（包括流式细胞仪）显示与她的PNH相关的溶血危险。尚未进行详尽的调查以揭示可能解释AI引发与溶血性疾病发作之间关系的潜在机制。

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