Successful Management of Obstructive Jaundice due to Gallstones with Eculizumab in a Patient with Paroxysmal Nocturnal Hemoglobinuria

Hiroki Kawano; Kentaro Minagawa; Kanako Wakahashi; Yuko Kawano; Akiko Sada; Toshimitsu Matsui; Hirotaka Hirano; Hideyuki Shiomi; Yonson Ku; Yoshio Katayama

doi:10.2169/internalmedicine.51.8202

CASE REPORTS

Successful Management of Obstructive Jaundice due to Gallstones with Eculizumab in a Patient with Paroxysmal Nocturnal Hemoglobinuria

Hiroki Kawano, Kentaro Minagawa, Kanako Wakahashi, Yuko Kawano, Akiko Sada, Toshimitsu Matsui, Hirotaka Hirano, Hideyuki Shiomi, Yonson Ku, Yoshio Katayama

Author information

Hiroki Kawano
Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
Kentaro Minagawa
Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
Kanako Wakahashi
Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
Yuko Kawano
Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
Akiko Sada
Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
Toshimitsu Matsui
Department of Hematology, Ono Municipal Hospital, Japan
Hirotaka Hirano
Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Japan
Hideyuki Shiomi
Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Japan
Yonson Ku
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Japan
Yoshio Katayama
Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan

Keywords: PNH, eculizumab, gallstone, cholecystectomy

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 18 Pages 2613-2616

DOI https://doi.org/10.2169/internalmedicine.51.8202

Details

Abstract

Paroxysmal nocturnal hemoglobinuria (PNH) makes patients susceptible to intravascular hemolysis and thrombosis, and it can be life-threatening in stressful situations. Eculizumab, a humanized monoclonal antibody that inhibits the complement protein C5, has been evaluated as a novel therapy for PNH. We herein describe the case of a 59-year-old Japanese woman with classic PNH, who had been successfully treated with eculizumab, but who later developed acute cholecystitis/cholangitis from gallstones. Although the severe obstructive jaundice requiring endoscopic therapy following cholecystectomy was complicated, critical intravascular hemolysis and thrombosis were not observed. Therefore, utilizing eculizumab during the peri-operative management of PNH patients should be carefully taken into consideration.

Corresponding author

Register with J-STAGE for free!