Collapsing focal segmental glomerulosclerosis following long-term treatment with oral ibandronate: case report and review of literature

BMC Cancer

Case Report

Ning Jia¹  Zita Shiue²  Behzad Najafian³  Fionnuala C. Cormack⁴  Julie R. Gralow⁵  Bin Xie⁵ 

[1] Department of Medical Oncology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China;Department of Medicine, University of Washington, 98195, Seattle, WA, USA;Department of Pathology, University of Washington, 98195, Seattle, WA, USA;Division of Nephrology, Harborview Medical Center, University of Washington, 98195, Seattle, WA, USA;Division of Oncology, Department of Medicine, Seattle Cancer Care Alliance, University of Washington, 98109, Seattle, WA, USA;

关键词: Collapsing glomerulopathy;    Focal segmental glomerulosclerosis;    Bisphosphonates;    Ibandronate;   

DOI  :  10.1186/s12885-015-1536-y

 received in 2014-11-25, accepted in 2015-07-09,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundRenal toxicity has been reported with bisphosphonates such as pamidronate and zolidronate but not with ibandronate, in the treatment of breast cancer patients with bone metastasis. One of the patterns of bisphosphonate-induced nephrotoxicity is focal segmental glomerulosclerosis (FSGS) or its morphological variant, collapsing focal segmental glomerulosclerosis (CFSGS).Case presentationWe describe a breast cancer patient who developed heavy proteinuria (protein/creatinine ratio 9.1) and nephrotic syndrome following treatment with oral ibandronate for 29 months. CFSGS was proven by biopsy. There was no improvement 1 month after ibandronate was discontinued. Prednisone and tacrolimus were started and she experienced a decreased in proteinuria.ConclusionIn patient who develops ibandronate-associated CFSGS, proteinuria appears to be at least partially reversible with the treatment of prednisone and/or tacrolimus if the syndrome is recognized early and ibandronate is stopped.

【 授权许可】

CC BY   
© Jia et al. 2015