Carfilzomib-Induced Thrombotic Microangiopathy: Focus on Pathogenesis

Drug-induced thrombotic microangiopathies present in similar fashion but have varied pathogenic mechanisms. Carfilzomib is an irreversible proteasome inhibitor. Since its initial approval as a single agent for the treatment of relapsed or refractory multiple myeloma in 2012, there have been increasi...

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Bibliographic Details
Published in:Journal of medical cases 2022-06, Vol.13 (6), p.274-280
Main Authors: Eigbire-Molen, Odianosen, Hermelin, Daniela, Blackall, Douglas
Format: Article
Language:English
Subjects:
Case Report
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Summary:Drug-induced thrombotic microangiopathies present in similar fashion but have varied pathogenic mechanisms. Carfilzomib is an irreversible proteasome inhibitor. Since its initial approval as a single agent for the treatment of relapsed or refractory multiple myeloma in 2012, there have been increasing reports of carfilzomib-induced thrombotic microangiopathy. However, the mechanism of this disease process is not fully understood. Without treatment, there is a high likelihood of end-organ damage, especially in the kidneys, and death. In recent reports, the lifesaving role of eculizumab, a terminal complement inhibitor, in managing and further preventing end-stage renal disease has been described. In this article, we present a case of carfilzomib-induced thrombotic microangiopathy in a patient with multiple myeloma and discuss the pathogenesis of thrombotic microangiopathy in this setting.
ISSN:1923-4155
1923-4163
DOI:10.14740/jmc3932