We report a case of a 42 year old male patient with a history of adrenocortical carcinoma, who was admitted with bilateral loss of sight and hypertension. Laboratory tests and further clinical evaluation showed hemolytic anemia, thrombocytopenia and acute renal failure. This was consistent with thrombotic microangiopathy / hemolytic uremic syndrome (HUS) due to gemcitabine therapy. The patient was successfully treated with prednisolon and antihypertensive drugs. Visus was completely restored, plasmapheresis was not needed. Clinicians should be aware of HUS as a rare complication of gemcitabine therapy.
