Carboquone,Cytosine Arabinosideの膀胱内注入療法による重症薬物shockの2例

Abstract

Two cases are reported whom an anaphylactic shock attacked as a side effect of the intravesical instillation of carboquone (CQ) and cytosine arabinoside (CA) for bladder tumor. Case I. A 74-year-old man had been treated with transurethral resection and intravesical instillation of CQ for bladder tumor (transitional cell carcinoma grade 2). At the 11th prophylactic intravesical instillation of CQ 10 mg and CA 40 mg, (totally 64th bladder instillation, CQ 640 mg, CA 2040 mg), an anaphylactic shock attacked the patient. On laboratory examination, the level of serum immunoglobulin E (IgE) was elevated on shock. Case 2. A 58-year-old man had been treated with intravesical instillation of CQ for bladder tumor (transitional cell carcinoma grade 2). An anaphylactic shock attacked the patient on his 4th prophylactic intravesical instillation of CQ 10 mg and CA 40 mg, (totally 39th instillation). The value of the serum IgE tended to be elevated on shock. But anti-CQ antibody was not detected on his serum by immunological examination. Prediction of the anaphylactic shock is so difficult that well-taken history of the patient and the serum IgE level seem to be important.