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Chemotherapy-induced Vascular Toxicity - Real-time In vivo Imaging of Vessel Impairment
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Collapsing glomerulopathy following anthracycline therapy.

Nasreen Mohamed1, Jeffrey Goldstein, Jeffrey Schiff

  • 1Department of Pathology, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|December 11, 2012
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Anthracycline chemotherapy can cause collapsing glomerulopathy, a severe kidney disease, in patients with hematolymphoid malignancies. This rare condition highlights the importance of considering drug toxicity in kidney injury.

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Area of Science:

  • Nephrology
  • Oncology
  • Pathology

Background:

  • Collapsing glomerulopathy is a severe form of focal segmental glomerulosclerosis (FSGS).
  • Anthracyclines are chemotherapy agents with known nephrotoxic potential.
  • Hematolymphoid malignancies are associated with various kidney diseases, including FSGS.

Observation:

  • Two cases of anthracycline-induced collapsing glomerulopathy are presented.
  • One patient had peripheral T-cell lymphoma; the other was a kidney transplant recipient treated for acute myeloid leukemia.
  • The temporal relationship suggests anthracyclines as the causative agent in these cases.

Findings:

  • Anthracycline use was linked to collapsing glomerulopathy in patients with hematolymphoid malignancies.
  • This association is rare, even in patients with malignancy or undergoing anthracycline treatment.
  • Predisposing host and environmental factors may interact with anthracycline exposure to trigger collapsing glomerulopathy.

Implications:

  • Anthracycline-induced collapsing glomerulopathy is a distinct clinical entity.
  • Awareness of this adverse effect is crucial for oncologists and nephrologists.
  • Further research into host factors may elucidate mechanisms of drug-induced FSGS.