Renal vascular lesions after chemotherapy with vinblastine, bleomycin, and cisplatin.
A 30 year old man with metastatic embryonal carcinoma became hypertensive during vinblastine, bleomycin, and cisplatin therapy. Three months after completion of therapy, accelerated hypertension occurred (blood pressure 210/140 mm Hg). Nitroprusside failed to control the hypertension, but captopril resulted in a prompt and sustained normalization of the blood pressure. The plasma renin activity was markedly elevated before therapy. Renal biopsy disclosed "onionskin" narrowing of the interlobular arteries and fibrin thrombosis of a majority of the afferent arterioles. A form of drug-induced renovascular hypertension is suggested.
D000328:Adult; D001761:Bleomycin / Q000009:adverse effects*; D002216:Captopril / Q000627:therapeutic use; D002945:Cisplatin / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D006801:Humans; D006978:Hypertension, Renovascular / Q000139:chemically induced / Q000188:drug therapy; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000139:chemically induced / Q000473:pathology; D008297:Male; D012078:Renal Artery Obstruction / Q000139:chemically induced*; D013736:Testicular Neoplasms / Q000188:drug therapy; D014747:Vinblastine / Q000009:adverse effects*
D001761:Bleomycin; D014747:Vinblastine; D002216:Captopril; D002945:Cisplatin