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舒尼替尼所致肾病综合征:肾细胞癌治疗的一种罕见并发症

Nephrotic Syndrome Due to Sunitinib: A Rare Complication of Treatment of Renal Cell Carcinoma.

作者信息

Malde Sunny, Kashiv Pranjal, Gupta Sushrut, Dubey Shubham, Balwani Manish, Pasari Amit, Sejpal Kapil N, Gurjar Prasad

机构信息

Nephrology, Jawaharlal Nehru Medical College, Wardha, IND.

Nephrology, Saraswati Kidney Care Center, Nagpur, IND.

出版信息

Cureus. 2024 Mar 14;16(3):e56178. doi: 10.7759/cureus.56178. eCollection 2024 Mar.

Abstract

This case report details a 62-year-old male with a history of right renal cell carcinoma (RCC) who developed sunitinib-induced nephrotic syndrome during treatment. The patient had a complex medical history, including a right nephrectomy in 2009, brain metastasis excisions in 2011 and 2012, and prolonged sunitinib therapy. Hypothyroidism, hypertension, and various surgeries further complicated his clinical picture. In April 2022, the patient presented with bilateral pedal edema, acute kidney injury superimposed on chronic kidney disease, and proteinuria. Upon examination, the decision was made to discontinue sunitinib, leading to the resolution of nephrotic syndrome. Adjustments in thyroxine dosage were made, and pharmacological interventions were employed to manage proteinuria and renal dysfunction. A multidisciplinary approach involving oncologists, nephrologists, and endocrinologists was essential in achieving a favorable outcome. The case highlights the intricate balance required in managing patients undergoing targeted cancer therapies, emphasizing the importance of vigilant monitoring, prompt intervention, and a collaborative approach for optimal patient care.

摘要

本病例报告详细介绍了一名62岁男性,有右肾细胞癌(RCC)病史,在治疗期间发生了舒尼替尼诱导的肾病综合征。该患者有复杂的病史,包括2009年右肾切除术、2011年和2012年脑转移瘤切除术以及长期舒尼替尼治疗。甲状腺功能减退、高血压和各种手术使他的临床情况更加复杂。2022年4月,患者出现双侧足部水肿、慢性肾脏病基础上的急性肾损伤和蛋白尿。经检查,决定停用舒尼替尼,肾病综合征得到缓解。调整了甲状腺素剂量,并采用药物干预来处理蛋白尿和肾功能不全。肿瘤学家、肾病学家和内分泌学家参与的多学科方法对于取得良好结果至关重要。该病例突出了在管理接受靶向癌症治疗的患者时所需的复杂平衡,强调了密切监测、及时干预以及协作方法对优化患者护理的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2e0/11015939/cbc80e6ea8d9/cureus-0016-00000056178-i01.jpg

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