[多发性骨髓瘤急性肾损伤的一种新病因：来那度胺诱发的急性间质性肾炎]
[A novel cause of acute kidney injury in multiple myeloma: Lenalidomide-induced acute interstitial nephritis].
作者信息
Fofana Aboubacar Sidiki, Bouaka Christophe, Alchahin Ghassan, Boncila Simona Dorina, Samaké Magara, Sy Seydou, Yattara Hamadoun, Fongoro Saharé, Torrents Julia, Valensi Rolande Cohen, Haussaire Delphine
机构信息
Unité de néphrologie de l'hôpital Fousseyni Daou de Kayes, BP 98, région de Kayes, Mali.
Service de néphrologie du Centre hospitalier de Martigues, 3, boulevard des Rayettes, 13500 Martigues, France.
出版信息
Nephrol Ther. 2022 Nov;18(6):565-569. doi: 10.1016/j.nephro.2022.03.004. Epub 2022 Jul 30.
INTRODUCTION
Lenalidomide is an immunomodulatory drug widely used in the treatment of multiple myeloma. Several cases of nephrotoxicity have been reported, but few have been documented histologically.
CASE PRESENTATION
We report a case of acute interstitial nephritis to lenalidomide in a 62-year-old patient with multiple myeloma after administration of the second course of chemotherapy according to the protocol combining bortezomib, lenalidomide and dexamethasone. The outcome was quickly favorable after stopping lenalidomide, with corticosteroid therapy.
CONCLUSION
Lenalidomide may be responsible for acute interstitial nephritis. When acute kidney injury occurs in myeloma, the nephrotoxicity of therapeutic agents should be considered in addition to the common causes of kidney failure. The chronology of events and the histological data are essential and guide the specific management.
引言
来那度胺是一种广泛用于治疗多发性骨髓瘤的免疫调节药物。已有数例肾毒性报告，但经组织学记录的病例很少。
病例报告
我们报告一例62岁多发性骨髓瘤患者，在按照硼替佐米、来那度胺和地塞米松联合方案进行第二疗程化疗后，出现来那度胺所致急性间质性肾炎。停用 来那度胺并给予皮质类固醇治疗后，病情很快好转。
结论
来那度胺可能是急性间质性肾炎的病因。骨髓瘤患者发生急性肾损伤时，除肾衰竭常见病因外，还应考虑治疗药物的肾毒性。事件发生的时间顺序和组织学数据至关重要，可为具体治疗提供指导。
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