Renal-limited ANCA-associated vasculitis during erlotinib treatment for lung carcinoma.
Aged
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
/ chemically induced
Carcinoma
/ drug therapy
Carcinoma, Non-Small-Cell Lung
/ drug therapy
ErbB Receptors
Erlotinib Hydrochloride
/ adverse effects
Female
Glomerulonephritis
/ chemically induced
Hematuria
/ chemically induced
Humans
Kidney
/ pathology
Lung
Lung Neoplasms
/ drug therapy
Male
Protein Kinase Inhibitors
/ adverse effects
Proteinuria
/ drug therapy
ANCA-associated vasculitis
Erlotinib
Kidney dysfunction
Lung carcinoma
Journal
CEN case reports
ISSN: 2192-4449
Titre abrégé: CEN Case Rep
Pays: Japan
ID NLM: 101636244
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
27
03
2021
accepted:
20
07
2021
pubmed:
27
7
2021
medline:
22
4
2022
entrez:
26
7
2021
Statut:
ppublish
Résumé
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) had clinical success in the treatment of non-small cell lung carcinoma (NSCLC). An effect of this drug on kidney has not been clarified and the occurrence of glomerulonephritis related to EGFR-TKI has rarely been reported. We present the case of a 71-year-old man with NSCLC who developed proteinuria and microscopic hematuria with the rise in a titer of MPO-ANCA, when 2 years and 3 months passed since the initiation of erlotinib, one of oral EGFR-TKI. Two serial biopsies support that ANCA-associated vasculitis may have been modified by the persistent use of erlotinib. We initiated intravenous pulse therapy with methylprednisolone followed by oral prednisone. The proteinuria has decreased and serum CRP was normalized. However, the serum creatinine level and hematuria did not change during the treatment period. While EGFR inhibition is implicated in protective control for glomerulonephritis, it may exacerbate vasculitis. Close monitoring of the kidney function and urinary findings is required during the use of EGFR inhibitors, such as erlotinib, because it may cause renal adverse events.
Identifiants
pubmed: 34309804
doi: 10.1007/s13730-021-00632-8
pii: 10.1007/s13730-021-00632-8
pmc: PMC8811088
doi:
Substances chimiques
Protein Kinase Inhibitors
0
Erlotinib Hydrochloride
DA87705X9K
ErbB Receptors
EC 2.7.10.1
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
67-72Informations de copyright
© 2021. Japanese Society of Nephrology.
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