Rhabdomyolysis-induced acute kidney injury in a cancer patient exposed to denosumab and abiraterone: a case report

BMC Nephrology

Aylin R. Rodan⁵  Allen R. Hendricks¹  Omkar U. Vaidya²  Rhea Bhargava³  Natalia A. Rocha⁴  Javier A. Neyra⁵ 

[1] Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas 75390-8516, TX, USA;Division of Nephrology, University of Missouri-Kansas City, Kansas City, Missouri, USA;Department of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA;Department of Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas 75390-8516, TX, USA;Division of Nephrology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas 75390-8516, TX, USA

关键词: Rhabdomyolysis;    Acute kidney injury;    Abiraterone;    Denosumab;   

Others  :  1222306
DOI  :  10.1186/s12882-015-0113-6

 received in 2015-04-12, accepted in 2015-07-17,  发布年份 2015

【 摘 要 】

Background

Denosumab and abiraterone were approved by the United States Food and Drug Administration in 2011 for the treatment of metastatic castration-resistant prostate cancer. Neither denosumab nor abiraterone is known to cause rhabdomyolysis.

Case presentation

A 76-year-old Caucasian man with metastatic prostate cancer presented with non-oliguric severe acute kidney injury (AKI) 3 weeks after receiving simultaneous therapy with denosumab and abiraterone. The patient had been on statin therapy for more than 1 year with no recent dose adjustments. His physical exam was unremarkable. Blood work on admission revealed hyperkalemia, mild metabolic acidosis, hypocalcemia, and elevated creatine kinase (CK) at 44,476 IU/L. Kidney biopsy confirmed the diagnosis of rhabdomyolysis-induced AKI. The patient responded well to intravenous isotonic fluids and discontinuation of denosumab, abiraterone, and rosuvastatin, with normalization of CK and recovery of kidney function.

Conclusion

We report the first case of biopsy-proven rhabdomyolysis-induced AKI in a cancer patient acutely exposed to denosumab and abiraterone. Whether one of these drugs individually, or the combination, was the bona fide culprit of muscle breakdown is unknown. Nonetheless, our report is hypothesis-generating for further investigations on the effect of these drugs on muscle cells.

【 授权许可】

   
2015 Neyra et al.

【 图 表 】

Figure 6.

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