title: Oxaliplatin-induced renal tubular vacuolization.
abstract: OBJECTIVE
  Chemotherapy with oxaliplatin is used for a wide range of malignancies. Unlike other platinum derivatives, oxaliplatin has less nephrotoxicity. However, in recent years, there have been multiple reports of different forms of renal toxicity related to this agent.
  
  
  METHODS
  A 40-year-old woman with colon adenocarcinoma developed jaundice, hematuria, and oliguria after the 36th cycle of oxaliplatin chemotherapy. Laboratory data revealed severe anemia, thrombocytopenia, increased creatinine, indirect hyperbilirubinemia, and high lactate dehydrogenase. A negative direct antiglobulin test and presence of <1% schistocytes in the peripheral blood smear stood against the diagnosis of immune-mediated hemolytic anemia or hemolytic uremic syndrome/thrombotic thrombocytopenic purpura. Renal biopsy was consistent with interstitial nephritis with tubular vacuolization in favor of drug-induced renal injury. Based on the Naranjo Probability Scale, the likelihood of oxaliplatin-induced renal injury in this case was probable.
  
  
  CONCLUSIONS
  To our knowledge, this is the first case report of renal tubular vacuolization with symptoms mimicking thrombotic microangiopathy in a patient on long-term chemotherapy with oxaliplatin.
  
  
  CONCLUSIONS
  Oxaliplatin can induce various forms of nephrotoxicity such as renal tubular vacuolization, acute tubular necrosis, renal tubular acidosis, and acute kidney injury secondary to hematological toxicity. Monitoring for renal function abnormalities and hemolysis should be considered during oxaliplatin-based chemotherapy.
authors.affiliation: Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali Yaghobi
authors.initials: AY
authors.lastname: Joybari
authors.forename: Samaneh
authors.initials: S
authors.lastname: Sarbaz
authors.forename: Payam
authors.initials: P
authors.lastname: Azadeh
authors.forename: S Abbas
authors.initials: SA
authors.lastname: Mirafsharieh
authors.forename: Ali
authors.initials: A
authors.lastname: Rahbari
authors.forename: Maryam
authors.initials: M
authors.lastname: Farasatinasab
authors.forename: Majid
authors.initials: M
authors.lastname: Mokhtari
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003110:Colonic Neoplasms / Q000188:drug therapy; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000473:pathology; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D000077150:Oxaliplatin
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin
keywords: AKI; HUS; Oxaliplatin; RTA; TTP