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蒽环类药物治疗后发生的肾小球病。

Collapsing glomerulopathy following anthracycline therapy.

机构信息

Department of Pathology, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.

出版信息

Am J Kidney Dis. 2013 May;61(5):778-81. doi: 10.1053/j.ajkd.2012.08.048. Epub 2012 Dec 6.

Abstract

We report 2 cases of anthracycline-induced collapsing glomerulopathy, one in a patient treated for peripheral T-cell lymphoma, and the other in a kidney transplant recipient treated for acute myeloid leukemia. Collapsing glomerulopathy is a distinct variant of focal segmental glomerulosclerosis (FSGS) that has been attributed to several different causes besides human immunodeficiency virus (HIV) in recent years. Previously, anthracycline use has been associated with FSGS, not otherwise specified (NOS). However, in the absence of therapy, various hematolymphoid malignancies have been associated with FSGS, NOS and collapsing glomerulopathy. In individuals who have hematolymphoid malignancy or are being treated with an anthracycline, the frequency of FSGS is extremely low. We suggest that in the following 2 patients, anthracycline use caused collapsing FSGS based on the temporal relationship, but also in the context of potentially underlying predisposing conditions. Host and environmental factors may interact to cause one morphologic form of FSGS or another.

摘要

我们报告了 2 例蒽环类药物诱导的塌陷性肾小球病,1 例发生在接受外周 T 细胞淋巴瘤治疗的患者中,另 1 例发生在接受急性髓系白血病治疗的肾移植受者中。塌陷性肾小球病是局灶节段性肾小球硬化症(FSGS)的一种特殊变体,近年来除人类免疫缺陷病毒(HIV)外,还有其他几种不同的病因与之相关。先前,蒽环类药物的使用与未特指的 FSGS 有关,但在没有治疗的情况下,各种血液淋巴恶性肿瘤与 FSGS、NOS 和塌陷性肾小球病有关。在患有血液淋巴恶性肿瘤或正在接受蒽环类药物治疗的患者中,FSGS 的频率极低。我们建议,在以下 2 例患者中,蒽环类药物的使用导致了塌陷 FSGS,这是基于时间关系,但也与潜在的潜在诱发条件有关。宿主和环境因素可能相互作用,导致 FSGS 的一种形态或另一种形态。

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