Carfilzomib-Induced Thrombotic Microangiopathy: Focus on Pathogenesis.
Publication Title
J Med Cases
Document Type
Article
Publication Date
6-13-2022
Keywords
Atypical hemolytic uremia syndrome; Carfilzomib; Eculizumab; Therapeutic plasma exchange; Thrombotic microangiopathy; oregon; portland
Abstract
Drug-induced thrombotic microangiopathies present in similar fashion but have varied pathogenic mechanisms. Carfilzomib is an irreversible proteasome inhibitor. Since its initial approval as a single agent for the treatment of relapsed or refractory multiple myeloma in 2012, there have been increasing reports of carfilzomib-induced thrombotic microangiopathy. However, the mechanism of this disease process is not fully understood. Without treatment, there is a high likelihood of end-organ damage, especially in the kidneys, and death. In recent reports, the lifesaving role of eculizumab, a terminal complement inhibitor, in managing and further preventing end-stage renal disease has been described. In this article, we present a case of carfilzomib-induced thrombotic microangiopathy in a patient with multiple myeloma and discuss the pathogenesis of thrombotic microangiopathy in this setting.
Clinical Institute
Cardiovascular (Heart)
Clinical Institute
Kidney & Diabetes
Specialty
Pathology & Laboratory Medicine
Specialty
Cardiology
Specialty
Hematology
