Pegylated-liposomal Doxorubicin-induced Glomerular Thrombotic Microangiopathy

Intern Med. 2024 Mar 11. doi: 10.2169/internalmedicine.3113-23. Online ahead of print.

Abstract

Pegylated liposomal doxorubicin (PLD) has emerged as a recent innovation within the realm of antineoplastic agents, distinguished by its incorporation of doxorubicin within the liposomal bilayer. Given the low risk of cardiotoxicity, the clinical use of PLD has been expanding. We encountered a patient who underwent extended PLD therapy for recurrent malignancy and subsequently developed PLD-associated thrombotic microangiopathy, which was diagnosed by a detailed pathophysiological assessment. This case underscores the importance of considering thrombotic microangiopathy as a potential differential diagnosis in patients presenting with unexplained hypertension and renal impairment during prolonged PLD monotherapy.

Keywords: drug induced kidney injury; liposome; ovarian cancer; polyethylene glycol (PEG); proteinuria.