Sunitinib-Induced Acute Interstitial Nephritis in a Thrombocytopenic Renal Cell Cancer Patient

Sunitinib, a multitargeted tyrosine Kkinase inhibitor (TKI), is currently the standard of care for patients with metastatic renal cell carcinoma. Renal adverse events associated with sunitinib include proteinuria, renal insufficiency secondary to focal segmental glomerulosclerosis (FSGS), and thromb...

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Bibliographic Details
Main Authors: Ibrahim Azar, Saghi Esfandiarifard, Pedram Sinai, Ali Wazir, Llewellyn Foulke, Syed Mehdi
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2017/6328204
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Summary:Sunitinib, a multitargeted tyrosine Kkinase inhibitor (TKI), is currently the standard of care for patients with metastatic renal cell carcinoma. Renal adverse events associated with sunitinib include proteinuria, renal insufficiency secondary to focal segmental glomerulosclerosis (FSGS), and thrombotic microangiopathy. We describe the second reported instance of biopsy-proven sunitinib-induced acute interstitial nephritis (AIN), in a challenging case complicated by thrombocytopenia. The case illustrates the importance of early diagnosis and intervention in ensuring long-term recovery from renal complications. Four other cases of AIN reported along with inhibition of the vascular endothelial growth factor (VEGF) by either TKI (sunitinib and sorafenib) or antibodies (bevacizumab) suggest a possible class effect. Given our experience, we recommend monitoring renal function with VEGF inhibition, and in the case of renal failure in the setting of an unclear diagnosis, we recommend prompt biopsy.
ISSN:2090-6706
2090-6714