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Bortezomib-induced acute interstitial nephritis.
Wisit Cheungpasitporn1, Nelson Leung2, S Vincent Rajkumar3
1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Summary
Bortezomib, a medication for multiple myeloma, can cause acute interstitial nephritis (AIN), a form of acute kidney injury. This case report details a patient who developed AIN from bortezomib, highlighting a previously unreported adverse effect.
Area of Science:
- Nephrology
- Oncology
- Pharmacology
Background:
- Acute interstitial nephritis (AIN) is a significant cause of acute kidney injury (AKI).
- Bortezomib is a proteasome inhibitor widely used in treating multiple myeloma and other plasma cell dyscrasias.
- The potential for bortezomib to induce AIN has not been previously documented.
Observation:
- A 47-year-old male patient with C3 glomerulonephritis was treated with bortezomib.
- The patient developed biopsy-proven allergic AIN during bortezomib therapy.
- Renal function improved upon bortezomib discontinuation and glucocorticoid treatment, but AKI recurred upon bortezomib re-initiation.
Findings:
- This is the first reported case of biopsy-proven acute interstitial nephritis attributed to bortezomib.
- The findings suggest a causal link between bortezomib and AIN.
- Recurrence of AIN upon re-challenge with bortezomib supports this association.
Implications:
- Clinicians should be aware of AIN as a potential adverse effect of bortezomib.
- Early recognition and management, including drug cessation and corticosteroid therapy, are crucial for improving renal outcomes.
- Further investigation into the mechanisms of bortezomib-induced AIN may be warranted.
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