• Internal medicine · Oct 2022

    Case Reports

    A Case of Thrombotic Microangiopathy, Podocytopathy, and Damage to the Renal Tubules with Severe Proteinuria and Acute Renal Dysfunction Induced by Lenvatinib.

    • Saki Nakashima, Akinari Sekine, Naoki Sawa, Yusuke Kawamura, Kei Kono, Keiichi Kinowaki, Masahiro Kawada, Eiko Hasegawa, Norio Akuta, Yoshiyuki Suzuki, Kenichi Ohashi, Kenmei Takaichi, Yoshifumi Ubara, and Junichi Hoshino.
    • Nephrology Center, Toranomon Hospital, Japan.
    • Intern. Med. 2022 Oct 15; 61 (20): 308330883083-3088.

    AbstractLenvatinib, a tyrosine kinase inhibitor (TKI), is a stronger inhibitor of vascular endothelial growth factor receptor, fibroblast growth factor receptors 1 to 4, and platelet-derived growth factor receptor (PDGFR) than other TKIs. We herein report a 77-year-old Japanese woman who received the minimum dose of lenvatinib for treatment of hepatocellular carcinoma. Within one month of starting treatment, she developed severe proteinuria, hypertension, and renal dysfunction. A kidney biopsy showed drug-induced thrombotic microangiopathy, podocytopathy, and polar vasculosis. We also observed damage to the renal tubules, where PDGFR is located. To our knowledge, this is the first report of lenvatinib-induced damage to the renal tubules.

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