"First reported case of ANCA-associated vasculitis induced by oxaliplatin, capecitabine, and trastuzumab"

作者全名："Huo, Bengang; Lin, Lirong; Zhao, Lei; Yu, Rongjie; Yang, Jurong"

作者地址："[Huo, Bengang; Lin, Lirong; Zhao, Lei; Yu, Rongjie; Yang, Jurong] Chongqing Med Univ, Affiliated Hosp 3, Gener Hosp, Dept Nephrol, Chongqing, Peoples R China; [Huo, Bengang] Army Med Univ, Army Med Ctr, Daping Hosp, Dept Nephrol, Chongqing, Peoples R China"

通信作者："Yang, JR (通讯作者)，Chongqing Med Univ, Affiliated Hosp 3, Gener Hosp, Dept Nephrol, Chongqing, Peoples R China."

来源：RENAL FAILURE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001107243700001

JCR分区：Q1

影响因子：3

年份：2023

卷号：45

期号：2

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结束页：　

文献类型：Article

关键词：Oxaliplatin; capecitabine; trastuzumab; vasculitis; ANCA

摘要："A 68-year-old male, who was undergoing XELOX plus trastuzumab therapy for gastric cancer, developed proteinuria, hematuria, and progressive increase in creatinine after 3 months. Subsequently, the patient also experienced hemoptysis, nasal bleeding. Chest CT examination shown pulmonary hemorrhage. The MRI of the nasopharynx ruled out nasopharyngeal cancer recurrence. The MPO and PR3 were elevated, and renal biopsy confirmed ANCA-related vasculitis, which affected the lungs, kidneys, and nasopharynx. Based on the review of the patient''s medical history and medication, it is believed that ANCA-related vasculitis was caused by XELOX plus trastuzumab chemotherapy, but it is difficult to confirm which specific drug caused it. After stopping XELOX plus trastuzumab chemotherapy, glucocorticoids and cyclophosphamide was given, the patient''s pulmonary hemorrhage and nasal bleeding stopped, and the lung lesions were absorbed. The renal function also improved. The patient later experienced pulmonary infection again, and tNGS indicated Legionella pneumophila and pulmonary tuberculosis infection. Despite anti-infection treatment, steroid dose was rapidly reduced. Ultimately, the patient gave up on treatment and eventually died."

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