title: Thrombotic microangiopathy associated with cetuximab, an epidermal growth factor receptor inhibitor .
abstract: Cetuximab is a chimeric human-murine monoclonal antibody that binds competitively and with high affinity to the epidermal growth factor receptor (EGFR) and is used to treat advanced squamous cell carcinoma of the head and neck. After receiving a total of six doses of cetuximab, a 72-year-old male presented with pretibial edema, acne-like skin rash, and nephrotic syndrome. The renal biopsy findings revealed features of thrombotic microangiopathy (TMA), with the expansion of the subendothelial zone, reduplication of the glomerular basement, and swelling of the endothelial cells. Nine weeks after the discontinuation of cetuximab, his pretibial edema had disappeared and proteinuria decreased. To our knowledge, this is the first report in which kidney biopsy revealed evidence of TMA due to cetuximab administration. Our report suggests that it may be prudent to monitor patients receiving cetuximab closely for the possible development of nephrotic syndrome. .
authors.forename: Mitsuteru
authors.initials: M
authors.lastname: Koizumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takahashi
authors.forename: Maki
authors.initials: M
authors.lastname: Murata
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Koichi
authors.initials: K
authors.lastname: Seta
authors.forename: Kensei
authors.initials: K
authors.lastname: Yahata
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D000068818:Cetuximab / Q000009:adverse effects*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy*; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology / Q000473:pathology*; D008297:Male; D057049:Thrombotic Microangiopathies / Q000139:chemically induced* / Q000150:complications / Q000473:pathology*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D066246:ErbB Receptors; D000068818:Cetuximab