JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v4i4.2367 jpsim.v4i4.2367 Case Report A Rare Case of Gemcitabine-Induced Thrombotic Microangiopathy (TMA) in the Treatment of Metastatic Nasopharyngeal Carcinoma, presenting to Nephrology Division Khyber Teaching Hospital, Peshawar Najumusaqib Muhammad muhammadnajumusaqib24881@import.invalid * Fazal Hamza Ullah Muhammad Sana Ahmed Annum Riaz Khan Zaryaab Ahmad Banaras Faizan faizanbanaras958@gmail.com * Khyber Teaching Hospital Peshawar *Correspondence: Muhammad Najumusaqib (muhammadnajumusaqib24881@import.invalid); Faizan Banaras (faizanbanaras958@gmail.com) 29 11 2023 2023 4 4 330 332 19 07 2023 14 09 2023 Copyright © 2023 The Author(s) 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Platinum-based concomitant chemo radiotherapy is considered the standard therapy in patients with advanced nasopharyngeal carcinoma worldwide. Gemcitabine, a nucleoside analogue of cytarabine primarily authorized in 1996 for the cure of unrespectable pancreatic carcinoma. Gemcitabine causes endothelial injury directly and therefore may lead to thrombotic microangiopathy in cancer population.

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