A Case of Imatinib Induced Nephrotic Syndrome in a Child with Chronic Myeloid Leukaemia

Authors

  • Mumtahena Mahmuda Assistant Registrar, Department of Paediatrics, Chittagong Medical College, Chattogram, Bangladesh
  • Tanzila Tabib Chowdhury Head and Assistant Professor, Department of Transfusion Medicine, Chittagong Medical College, Chattogram, Bangladesh
  • Mohammed Maruf ul Quader Associate Professor, Department of Paediatric Nephrology, Chittagong Medical College, Chattogram, Bangladesh
  • AKM Rezaul Karim Professor and Head, Department of Paediatric Haemato oncology, Chittagong Medical College, Chattogram, Bangladesh
  • Joydip Nandy Assistant Registrar, Department of Paediatrics, Chittagong Medical College, Chattogram, Bangladesh
  • Md Naoshad Khan Indoor Medical Officer, Department of Haematology, Chittagong Medical College, Chattogram, Bangladesh

DOI:

https://doi.org/10.3329/jbcps.v41i2.64507

Keywords:

Imatinib, Nephrotic Syndrome, Chronic Myeloid Leukaemia.

Abstract

Background:Tyrosin kinase inhibitors (TKI) are used as a targeted therapy for the treatment of chronic myeloid leukaemia and Philadelphia chromosome positive acute lymphoblastic leukaemia. Increasing use of TKI has been associated with hypertension, proteinuria and acute kidney injury. There are only afew reports of adults with TK -inhibitor associated nephrotic syndrome.But TK inhibitor associated Nephrotic syndrome is very rare in paediatric age group.

Case:A -6- year old boy presented with fever, anaemia, splenomegaly, leucocytosis and finally diagnosed as accelerated phase of chronic myeloid leukaemia (CML) by bone marrow study.He achieved clinical and haematological remission with Imatinib. But developed generalized oedema and was found to have massive proteinuria and microscopic haematuria after three and half months. Renal biopsy revealed focal segmental glomerulosclerosis. Imatinib along with Prednisolone, 60 mg/m2/ day was added to treat nephrotic syndrome. Imatinib discontinued as the patient did not achieve complete remission. After one week of Imatinib withdrawal and five weeks of daily prednisolone the boy attained complete remission of nephrotic syndrome.

Conclusion:Tyrosine Kinase inhibitors are important therapies in paediatric cancer and their use is expanding. Timely recognition of renal adverse effectsfor TK inhibitors can aid in the proper management of cancer patients.

J Bangladesh Coll Phys Surg 2023; 41: 170-172

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Published

2023-03-30

How to Cite

Mahmuda, M. ., Chowdhury, T. T. ., Quader, M. M. ul, Karim, A. R. ., Nandy, J. ., & Khan, M. N. . (2023). A Case of Imatinib Induced Nephrotic Syndrome in a Child with Chronic Myeloid Leukaemia. Journal of Bangladesh College of Physicians and Surgeons, 41(2), 170–172. https://doi.org/10.3329/jbcps.v41i2.64507

Issue

Section

Case Reports