Kidney Research Institute, Division of Nephrology, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, China.
BMC Nephrol. 2022 Mar 19;23(1):112. doi: 10.1186/s12882-021-02656-9.
Regorafenib belongs to a sub-group of small-molecule multi-targeted tyrosine kinase inhibitors(TKIs). In various studies with respect to the side-effect of regorafenib, drug-associated proteinuria standardly qualified to be defined as nephrotic syndrome was rarely reported as well as the relation of regorafenib with the occurrence and development of thrombotic microangiopathy (TMA).
In this case report and literature review, we presented a 62-year-old patient receiving regorafenib for metastatic colon cancer, manifesting abundant proteinuria, in which TMA was also diagnosed through renal biopsy. As far as we were concerned, this was the first reported in terms of regorafenib-induced TMA confirmed by renal biopsy.
This case indicates that regorafenib, a kind of TKIs may result in TMA, which is a rare but life-threatening complication of cancer treatment drug. Insights from this case might help physicians diagnose rare forms of TMA and adjust treatment for patients in a timely manner.
瑞戈非尼属于小分子多靶点酪氨酸激酶抑制剂(TKI)亚类。在多项关于瑞戈非尼副作用的研究中,药物相关性蛋白尿标准定义为肾病综合征的报道很少,也很少有瑞戈非尼与血栓性微血管病(TMA)发生和发展的关系的报道。
在本病例报告和文献复习中,我们介绍了一位 62 岁的转移性结肠癌患者接受瑞戈非尼治疗,表现为大量蛋白尿,通过肾活检诊断为 TMA。据我们所知,这是首例通过肾活检证实的瑞戈非尼引起的 TMA。
本病例表明,TKI 类药物瑞戈非尼可能导致 TMA,这是癌症治疗药物罕见但危及生命的并发症。本病例的启示可能有助于医生及时诊断罕见形式的 TMA 并为患者调整治疗方案。