埃克替尼相关局灶增生型IgA肾病和急性肾小管损伤  

Icotinib‑associated focal proliferative IgA nephropathy and acute renal tubule injury

作　　者：梁永利 张丽新 杨宏昕 谭昭[2] 郭小彬 刘琳[2] Liang Yongli;Zhang Lixin;Yang Hongxin;Tan Zhao;Guo Xiaobin;Liu Lin(Department of Pharmacy,Inner Mongolia Autonomous Region People′s Hospital,Huhehot 010017,China;Department of Nephrology,China‑Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]内蒙古自治区人民医院药学处,呼和浩特010017 [2]中日友好医院肾内科,北京100029

出　　处：《药物不良反应杂志》2023年第2期112-114,共3页Adverse Drug Reactions Journal

摘　　要：1例68岁男性肺腺癌患者接受埃克替尼125 mg口服、3次/d和康莱特软胶囊2.7 g口服、4次/d治疗。用药前血清肌酐(Scr)91μmol/L。用药29 d后患者出现泡沫尿、乏力、胸闷、食欲下降、颈部及胸前皮肤出现红色皮疹等,未予干预,共用药76 d。实验室检查示Scr 167μmol/L,免疫球蛋白A(IgA)4090 mg/L,尿蛋白2 g/L,24 h尿蛋白2.61 g,尿红细胞6.8个/高倍视野,尿α微球蛋白66.9 mg/L。病理检查结果示局灶增生型IgA肾病和急性肾小管损伤,考虑由埃克替尼引起可能性大。嘱患者低蛋白饮食并予对症治疗,80 d后,患者Scr 189μmol/L、尿蛋白2 g/L。此后患者失访。A 68‑year‑old male patient with lung adenocarcinoma was treated with icotinib 125 mg thrice daily orally and Kanglaite soft capsules(康莱特软胶囊)2.7 g orally 4 times daily.The patient′s serum creatinine(Scr)was 91μmol/L before the medication.He developed foamy urine,fatigue,chest tightness,loss of appetite,and red rash on the neck and chest skin 29 days after the medication.No intervention was given and the patient received a total of 76 days of medication.Laboratory tests showed Scr 167μmol/L,immunoglobulin A(IgA)4090 mg/L,urine protein 2 g/L,urinary protein 2.61 g per 24 hours,urinary red blood cells 6.8/high power field,and urineαmicroglobulin 66.9 mg/L.Through pathological examination,the patient was diagnosed with focal proliferative IgA nephropathy and acute renal tubule injury,which was considered to be related to icotinib.Low protein diet and the symptomatic treatments were given.After 80 days of treatment,the patient′s Scr was 189μmol/L and urine protein was 2 g/L.After that,the patient was lost to follow‑up.

关 键 词：蛋白酪氨酸激酶类 肾病 埃克替尼 

分 类 号：R692[医药卫生—泌尿科学]