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, Junichi Hoshino
Abstract
Lenvatinib, 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.