title: Diffuse proliferative glomerulonephritis associated with cetuximab, an epidermal growth factor receptor inhibitor.
abstract: Cetuximab is an epidermal growth factor receptor inhibitor used for advanced squamous cell carcinoma of the head and neck. We report an unusual case of diffuse proliferative and crescentic glomerulonephritis in a 67-year-old man in close temporal association with cetuximab treatment for recurrent oral squamous cell carcinoma. The patient presented with acute renal failure and nephrotic-range proteinuria. Kidney biopsy showed diffuse proliferative and focally crescentic glomerulonephritis associated with immunoglobulin A (IgA)-dominant immune-complex deposition within glomerular capillary walls and mesangium. The patient showed dramatic improvement in kidney function after discontinuation of cetuximab therapy and a short course of cyclophosphamide and steroid. The clinical outcome of this case suggests that cetuximab therapy may trigger or exacerbate IgA-mediated glomerular injury and warrants close monitoring of kidney function in patients treated with this epidermal growth factor receptor inhibitor.
authors.affiliation: Department of Pathology, University of Washington Medical Center, Seattle, WA 98195, USA. ksasaki@uw.edu
authors.forename: Kotaro
authors.initials: K
authors.lastname: Sasaki
authors.forename: Eric
authors.initials: E
authors.lastname: Anderson
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Shankland
authors.forename: Roberto F
authors.initials: RF
authors.lastname: Nicosia
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D000068818:Cetuximab; D005921:Glomerulonephritis / Q000139:chemically induced*; D006258:Head and Neck Neoplasms / Q000188:drug therapy; D006801:Humans; D008297:Male; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068818:Cetuximab