Abstract | RATIONALE: PATIENT CONCERN: DIAGNOSIS AND INTERVENTION: OUTCOMES: Her renal function progressively deteriorated; by month 20 after treatment commencement, her serum creatinine level had increased from 1.59 to 3.74 mg/dL. The first kidney biopsy revealed marked glomerular and endothelial cell damage. Her medication was stopped, but no improvement was evident. At 5 months after the first biopsy, her serum creatinine level had increased to 5.46 mg/dL; a second kidney biopsy revealed focal segmental glomerular sclerosis and marked tubulointerstitial fibrosis. She was started on hemodialysis. LESSONS: We describe a patient with a metastatic melanoma who developed progressive kidney failure during treatment with dabrafenib and trametinib. The most prominent microscopy findings were glomerular endothelial damage in the initial kidney biopsy and accelerated glomerular sclerosis and tubulointerstitial fibrosis in the follow-up biopsy. We hypothesize that a decreased renal reserve and impairment of kidney repair capacity caused by inhibition of B-RAF, a downstream mediator of vascular endothelial growth factor, may explain the progressive kidney injury.
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Authors | Eunmi Jo, Harin Rhee |
Journal | Medicine
(Medicine (Baltimore))
Vol. 101
Issue 1
Pg. e28485
(Jan 07 2022)
ISSN: 1536-5964 [Electronic] United States |
PMID | 35029901
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. |
Chemical References |
- Imidazoles
- Oximes
- Pyridones
- Pyrimidinones
- Vascular Endothelial Growth Factor A
- trametinib
- Creatinine
- Proto-Oncogene Proteins B-raf
- Mitogen-Activated Protein Kinase Kinases
- dabrafenib
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Topics |
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols
- Creatinine
- Diabetes Mellitus, Type 2
- Female
- Fibrosis
- Humans
- Imidazoles
(administration & dosage, toxicity)
- Melanoma
(drug therapy, pathology)
- Mitogen-Activated Protein Kinase Kinases
(therapeutic use)
- Nephritis, Interstitial
(chemically induced)
- Oximes
(administration & dosage, adverse effects, toxicity)
- Proto-Oncogene Proteins B-raf
- Pyridones
(administration & dosage, toxicity)
- Pyrimidinones
(administration & dosage, toxicity)
- Skin Neoplasms
(drug therapy, pathology)
- Vascular Endothelial Growth Factor A
(therapeutic use)
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