Tumour necrosis factor-α

Reactions 731 - 12 Dec 1998 S Tumour necrosis factor-α Systemic inflammatory response syndrome: case report A 34-year-old man developed systemic inflammatory response syndrome after a large dose of tumour necrosis factor-α (TNF-α) was released into his systemic circulation following isolated liver perfusion with this agent for nonresectable bilateral liver metastases. The patient received an isolated hyperthermic (40.5°) liver perfusion with TNF-α 300µg and melphalan for 60 minutes. Inadvertently, an large dose of TNF-α was released into his systemic circulation because of insufficient washout using a small diameter perfusion cannula. The man’s serum concentration of TNF-α was 1466 pg/ml, 30 minutes after reperfusion. Six hours later, he required intensive care treatment for marked hypotension and intensive volume replacement with 11L of fluid. He required another 38L of fluid over the following 2 days. He also developed generalised capillary leak syndrome and his pulmonary function deteriorated and he needed mechanical ventilation. The patient was discharged 98 days after he underwent the perfusion procedure. Oldhafer KJ, et al. High-dose tumor necrosis factor-alpha leads to the systemic inflammatory response syndrome. American Journal of Medicine 105: 346-347, Oct 1998 - Germany 800716390 1 Reactions 12 Dec 1998 No. 731 0114-9954/10/0731-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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Transcript of Tumour necrosis factor-α

Reactions 731 - 12 Dec 1998

STumour necrosis factor-αSystemic inflammatory response syndrome: casereport

A 34-year-old man developed systemic inflammatoryresponse syndrome after a large dose of tumour necrosisfactor-α (TNF-α) was released into his systemic circulationfollowing isolated liver perfusion with this agent fornonresectable bilateral liver metastases.

The patient received an isolated hyperthermic (40.5°) liverperfusion with TNF-α 300µg and melphalan for 60 minutes.Inadvertently, an large dose of TNF-α was released into hissystemic circulation because of insufficient washout using asmall diameter perfusion cannula.

The man’s serum concentration of TNF-α was 1466 pg/ml,30 minutes after reperfusion. Six hours later, he requiredintensive care treatment for marked hypotension and intensivevolume replacement with 11L of fluid. He required another38L of fluid over the following 2 days. He also developedgeneralised capillary leak syndrome and his pulmonaryfunction deteriorated and he needed mechanical ventilation.The patient was discharged 98 days after he underwent theperfusion procedure.Oldhafer KJ, et al. High-dose tumor necrosis factor-alpha leads to the systemicinflammatory response syndrome. American Journal of Medicine 105: 346-347,Oct 1998 - Germany 800716390