Daunorubicin
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Collapsing glomerulopathy: 2 case reports Two men developed collapsing glomerulopathy during treatment with daunorubicin [dosages and routes not stated]. A 44-year-old man with peripheral T-cell lymphoma received 2 cycles of daunorubicin as part of his chemotherapy regimen. He was hospitalised due to a seizure episode approximately 11 weeks after starting treatment. At that time, he also had oliguric kidney failure and transaminitis. A kidney biopsy showed five glomeruli with segmental or global tuft prolapse and hyperplastic podocytes with prominent protein resorption droplets and vacuoles. Many mildly shrunken glomeruli were also seen without endocapillary hypercellularity or mesangial expansion. He died of septic shock and respiratory failure. A 42-year-old man, whose history included kidney and liver transplantation, was diagnosed with acute myeloid leukaemia. He received daunorubicin as part of chemotherapy induction, which was followed by a cycle of daunorubicin as consolidation therapy after remission. Approximately 9 weeks after starting treatment, he had a serum creatinine level of 3.1 mg/dL. A kidney biopsy showed 11 of 39 glomeruli that were globally sclerosed. In addition, two glomeruli exhibited hyperplastic podocytes containing vacuoles and protein resorption droplets with global glomerular tuft wrinkling collapse. He was treated with steroids and an angiotensin receptor blocker. His serum creatinine level decreased to 1.8 mg/dL, and he proceeded to receive an allogeneic bone marrow transplant. Author comment: "The anthracycline antibiotics doxorubicin and daunorubicin (daunomycin) are chemotherapeutic agents commonly used to treat various hematolgic malignancies. . . In our 2 cases, the temporal sequence helps identify anthracycline as a cause or cofactor precipitating collapsing [focal segmental glomerulosclerosis]." Mohamed N, et al. Collapsing glomerulopathy following anthracycline therapy. American Journal of Kidney Diseases 61: 778-781, No. 5, May 2013. Available 803086975 from: URL: http://dx.doi.org/10.1053/j.ajkd.2012.08.048 - Canada
0114-9954/10/1452-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 18 May 2013 No. 1452
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