Hemolysis attributed to high dose vitamin C:Two case reports  

作　　者：Shi-Wan Wang Xiao-Wei Zhang Jin-Xiu Qu Yi-Zhong Rao Shuai Lu Bing Wang Jia He Yuan Zhao Ben-Qiang Rao 

机构地区：[1]Center for Oncology Nutrition and Metabolism,Beijing Shijitan Hospital,Capital Medical University/Key Laboratory of Cancer FSMP for State Market Regulation,Beijing 100038,China

出　　处：《World Journal of Clinical Cases》2024年第17期3168-3176,共9页世界临床病例杂志

基　　金：Supported by The National Natural Science Foundation of China,No.82074061;The National Key Research and Development Program of China,No.2022YFC2009600.

摘　　要：BACKGROUND High-dose vitamin C treatment(HVCT)can reduce the adverse effect of chemotherapy and enhance the effect of antitumor therapy,which has been considered one of the safest alternative treatments.However,the severity of its adverse effects may have been underestimated.The most serious adverse effect is hemolysis,which may result in acute kidney injury or death.Although glucose-6-phosphate dehydrogenase(G6PD)deficiency is considered to be the main cause,the probability and pathological mechanism are not completely understood,leading to a lack of effective and standardized treatment methods.CASE SUMMARY Two patients with colorectal cancer developed hemolytic anemia after using 1 g/kg HVCT.In contrast to previous cases,the lowest hemoglobin level in the two cases was<50 g/L,which was lower than previously reported.This may be because Case 1 had chronic hepatitis B for many years,which caused abnormal liver reserve function,and Case 2 had grade II bone marrow suppression.Both patients improved and were discharged after blood replacement therapy.Our cases had the most severe degree of hemolysis but the best prognosis,suggesting that our treatment may be helpful for rescue of drug-induced hemolysis.This is the first review of the literature on hemolysis caused by HVCT,and we found that all patients with G6PD deficiency developed hemolysis after HVCT.CONCLUSION G6PD deficiency should be considered as a contraindication to HVCT,and it is not recommended for patients with bone marrow suppression,moderate-tosevere anemia,hematopoietic abnormalities,or abnormal liver and kidney function.Early blood purification and steroid therapy may avoid acute kidney injury or death caused by HVCT-related hemolytic anemia.

关 键 词：HEMOLYSIS Vitamin C Adverse effects Acute kidney injury CANCER Case report 

分 类 号：R739.4[医药卫生—肿瘤]