Partial fanconi syndrome induced by imatinib therapy: a novel cause of urinary phosphate loss.
Imatinib mesylate (Gleevec, Glivec; Novartis, Basel, Switzerland) is a specific tyrosine kinase inhibitor that has become the gold-standard treatment for patients with chronic myeloid leukemia. Several tyrosine kinases inhibited by imatinib are expressed in the kidney, and although the drug is usually well tolerated, several cases of acute renal failure were reported. We describe for the first time a case of a patient treated by imatinib for chronic myeloid leukemia who developed partial Fanconi syndrome with mild renal failure, which leads to a discussion of the pathophysiological characteristics of imatinib-induced renal toxicity. Patients on long-term imatinib treatment should be monitored for renal failure, as well as proximal tubule dysfunction, including hypophosphatemia.
François
Helene
H
AP-HP, Assistance Publique-Hôpitaux de Paris, Department of Nephrology and Dialysis, Tenon Hospital, Paris, France. helene.francois@tnn.aphp.fr
Coppo
Paul
P
Hayman
Jean-Philippe
JP
Fouqueray
Bruno
B
Mougenot
Béatrice
B
Ronco
Pierre
P
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001549:Benzamides; D005198:Fanconi Syndrome / Q000139:chemically induced* / Q000503:physiopathology / Q000652:urine; D005260:Female; D006801:Humans; D017674:Hypophosphatemia / Q000139:chemically induced*; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008875:Middle Aged; D010710:Phosphates / Q000652:urine*; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects*; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects*
D000970:Antineoplastic Agents; D001549:Benzamides; D010710:Phosphates; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases