安罗替尼致肾脏血栓性微血管病  

Anlotinib-induced renal thrombotic microangiopathy

作　　者：张悦怡 叶文玲[2] 李明喜[2] 叶葳[2] 文煜冰[2] 郑可[2] 李雪梅[2] 艾三喜[2] Zhang Yueyi;Ye Wenling;Li Mingxi;Ye Wei;Wen Yubing;Zheng Ke;Li Xuemei;Ai Sanxi(Department of Medicine,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Nephrology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院内科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院肾内科,北京100730

出　　处：《药物不良反应杂志》2021年第9期497-499,共3页Adverse Drug Reactions Journal

基　　金：北京协和医学院研究生教育教学改革项目(10023201800101)。

摘　　要：1例64岁女性患者因直肠腺癌伴双肺多发转移行直肠癌根治术,术后接受奥沙利铂联合卡培他滨治疗无效,改用安罗替尼12 mg/d口服,治疗2周,停药1周,3周为1个周期。在安罗替尼第2周期治疗期间出现水肿、蛋白尿、高血压和低白蛋白血症,血清肌酐正常,肾脏穿刺病理学提示肾脏血栓性微血管病,符合抗血管内皮生长因子药物相关肾损伤的临床和病理表现。停用安罗替尼,给予降压及对症治疗,水肿逐渐消退,尿蛋白逐渐减少,3个月后尿蛋白转阴,血白蛋白恢复正常。A 64-year-old female patient received postoperative adjuvant chemotherapy with oxaliplatin and capecitabine after radical resection of rectal cancer for rectal adenocarcinoma with multiple lung metastases.Due to poor therapeutic effect,the patient was switched to anlotinib treatment at a dose of 12 mg/d orally for 2 weeks with a 1-week break and 3 weeks was one cycle.During the second cycle of anlotinib treatment,the patient developed edema,proteinuria,hypertension,and hypoalbuminemia,with normal serum creatinine.The renal pathology suggested renal thrombotic microangiopathy,which was in line with the clinical and pathological manifestations of drug-related renal injury due to anti-vascular endothelial growth factor.After discontinuation of anlotinib and receiving symptomatic treatment such as blood pressure control,the edema gradually subsided along with remission of proteinuria.Three months later,the patient had no proteinuria and the serum albumin was normal.

关 键 词：抗肿瘤药 血栓性微血管病 安罗替尼 

分 类 号：R969[医药卫生—药理学]