Advertisement

International Journal of Clinical Pharmacy

, Volume 33, Issue 1, pp 58–60 | Cite as

Methemoglobinemia and hemolytic anemia after rasburicase administration in a child with leukemia

  • T. BautersEmail author
  • V. Mondelaers
  • H. Robays
  • H. De Wilde
  • Y. Benoit
  • B. De Moerloose
Case Report

Abstract

Case We report a case of simultaneous methemoglobinemia and hemolytic anemia, probably related to the use of rasburicase, in a child starting treatment for acute lymphoblastic leukemia (ALL). In addition, the patient developed symptoms of pancreatitis. All complications resolved after 3 days of supportive therapy. Conclusion Although usually well tolerated in pediatrics, physicians prescribing rasburicase should be aware of these possible life-threatening adverse reactions.

Keywords

Clinical pharmacy Hemolytic anemia  Methemoglobinemia Pancreatitis Pediatric hemato-oncology Rasburicase 

Notes

Conflicts of interest

The authors have no conflicts of interest.

References

  1. 1.
    Ueng S. Rasburicase (Elitek): a novel agent for tumor lysis syndrome. Proc (Bayl Univ Med Cent). 2005;18(3):275–9.Google Scholar
  2. 2.
    Pui CH, Mahmoud HH, Wiley JM, Woods GM, Leverger G, Camitta B, et al. Recombinant urate oxidase for the prophylaxis or treatment of hyperuricemia in patients with leukemia or lymphoma. J Clin Oncol. 2001;19(3):697–704.PubMedGoogle Scholar
  3. 3.
    Cairo MS. Prevention and treatment of hyperuricemia in hematological malignancies. Clin Lymphoma. 2002; Suppl 1:S26–31.Google Scholar
  4. 4.
    de Bont JM, Pieters R. Management of hyperuricemia with rasburicase review. Nucleosides Nucleotides Nucleic Acids. 2004;23(8–9):1431–40.PubMedCrossRefGoogle Scholar
  5. 5.
    Browning LA, Kruse J. Hemolysis and methemoglobinemia secondary to rasburicase administration. Ann Pharmacother. 2005;39(11):1932–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Maher JF, Rath CE, Schreiner GE. Hyperuricemia complicating leukemia: treatment with allopurinol and dialysis. Arch Intern Med. 1969;123(2):198–200.PubMedCrossRefGoogle Scholar
  7. 7.
    E-Compendium. Scientific Leaflet Fasturtec (in Flemish). Available from: http://www.ecompendium.be/. Accessed on 12 May 2010.
  8. 8.
    Goldman SC, Holcenberg JS, Finklestein JZ, Hutchinson R, Kreissman S, Johnson FL, et al. A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis. Blood. 2001;97(10):2998–3003.PubMedCrossRefGoogle Scholar
  9. 9.
    Kizer N, Martinez E, Powell M. Report of two cases of rasburicase-induced methemoglobinemia. Leuk Lymphoma. 2006;47(12):2648–50.PubMedCrossRefGoogle Scholar
  10. 10.
    Identifying Adverse Drug Reactions. Available from http://qmweb.dads.state.tx.us/MedSim/Naranjo.htm. Accessed on 14 Apr 2010.
  11. 11.
    Borinstein SC, Xu M, Hawkins DS. Methemoglobinemia and hemolytic anemia caused by rasburicase administration in a newly diagnosed child with Burkitt lymphoma/leukemia. Pediatr Blood Cancer. 2008;50(1):189.PubMedCrossRefGoogle Scholar
  12. 12.
    Bhat P, Sisler I, Collier AB 3rd. Exchange transfusion as treatment for rasburicase induced methemoglobinemia in a glucose-6-phosphate dehydrogenase deficient patient. Pediatr Blood Cancer. 2008;51(4):568.PubMedCrossRefGoogle Scholar
  13. 13.
    Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356(9237):1255–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • T. Bauters
    • 1
    Email author
  • V. Mondelaers
    • 2
  • H. Robays
    • 1
  • H. De Wilde
    • 3
  • Y. Benoit
    • 2
  • B. De Moerloose
    • 2
  1. 1.Department of PharmacyGhent University HospitalGhentBelgium
  2. 2.Department of Pediatric Hemato-OncologyGhent University HospitalGhentBelgium
  3. 3.Department of Pediatric CardiologyGhent University HospitalGhentBelgium

Personalised recommendations