Capecitabine-Related Thrombotic Microangiopathy.

IF 1.6 Q4 ONCOLOGY Journal of Gastrointestinal Cancer Pub Date : 2024-06-01 Epub Date: 2024-01-04 DOI:10.1007/s12029-023-00993-6
Francisco J Pelegrín Mateo, Anna Dominguez Guasch, Jose Andrés Guerrero Pineda, Anna Cristina Virgili Manrique, Berta Martín Cullell, David Páez López-Bravo, Javier Gavira Díaz, Aida Piedra Cascón, Xoana Barros Freiria
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Abstract

Purpose: Renal injury is common in cancer patients and its etiology is multifactorial. Different patterns of renal histological lesions have been described in relation to oncologic treatments, notably acute tubular necrosis and tubulointerstitial nephritis, but also thrombotic microangiopathy (TMA).

Methods: We report a case of TMA secondary to capecitabine in an 82-year-old woman diagnosed with localized colon adenocarcinoma.

Results: The patient, with previous normal kidney function, presented with renal impairment during the fourth cycle of chemotherapy. After potential nephrotoxic factors were ruled out, capecitabine was discontinued and a kidney biopsy was performed, which displayed TMA lesions. An improvement in renal function was observed after definitive cessation of cytotoxic chemotherapy. Although rare, renal toxicity in the form of TMA may be associated with the use of cytotoxic agents such as gemcitabine, but there is no reported evidence of its association to capecitabine. Early withdrawal of the drug and nephrology consultation is necessary to prevent irreversible damage.

Conclusion: We describe, to our knowledge, the first case reported in the literature regarding the possible association of TMA and capecitabine.

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卡培他滨相关的血栓性微血管病。
目的:肾损伤是癌症患者的常见病,其病因是多因素的。肾组织学病变的不同模式与肿瘤治疗有关,主要是急性肾小管坏死和肾小管间质性肾炎,也包括血栓性微血管病(TMA):我们报告了一例继发于卡培他滨的 TMA 病例,患者是一名 82 岁的女性,被诊断为局部结肠腺癌:患者之前肾功能正常,在第四个化疗周期出现肾功能损害。在排除了潜在的肾毒性因素后,患者停用了卡培他滨,并进行了肾活检,结果显示存在 TMA 病变。在明确停止细胞毒性化疗后,患者的肾功能有所改善。以 TMA 形式出现的肾毒性虽然罕见,但可能与使用吉西他滨等细胞毒性药物有关,但目前尚无与卡培他滨相关的证据报道。为防止不可逆转的损害,必须尽早停药并咨询肾内科:据我们所知,我们描述了文献中报道的第一例 TMA 与卡培他滨可能相关的病例。
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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
121
期刊介绍: The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology:  This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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