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Renal tubular necrosis associated with anagrelide administration: a case report

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Abstract

A 62-year-old female patient with essential thrombocythemia experienced rapid renal dysfunction and was subsequently referred to our hospital. Further investigations did not reveal any significant abnormalities except for a slight increase in urinary β2-microglobulin levels. A renal biopsy was performed to investigate the cause of her renal dysfunction, revealing acute tubular necrosis, interstitial edema, and arteriosclerosis. No significant glomerular lesions were observed. Immunofluorescence staining and electron microscopy showed no abnormalities. She had been using anagrelide for 4 years, and her dosage was increased from 2.0 to 3.0 mg/day 10 months before her initial admission. Her renal function began to deteriorate 2 months after the anagrelide dosage increase. Although 0.625 mg of bisoprolol was initiated for tachycardia 3 months after the anagrelide dosage adjustment, we suspected that the acute tubular necrosis was associated with anagrelide administration. After transitioning from anagrelide to hydroxyurea and discontinuing bisoprolol, her renal function improved. This case suggests the importance of considering anagrelide as a potential cause of renal dysfunction in patients using this medication. Therefore, renal biopsy, combined with a comprehensive medical history, is crucial for evaluating the etiology of renal injury in such cases.

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Authors and Affiliations

  1. Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Atsushi Sawase, Mineaki Kitamura, Misato Morimoto, Haruka Fukuda, Tadashi Uramatsu, Hiroshi Yamashita & Tomoya Nishino

  2. Department of Nephrology, Nagasaki Harbor Medical Center, Nagasaki, Japan

    Atsushi Sawase, Mineaki Kitamura, Haruka Fukuda & Hiroshi Yamashita

  3. Department of Nephrology, Nijigaoka Hospital, Nagasaki, Japan

    Tadashi Uramatsu

  4. Department of Pathology, School of Medicine, University, of Occupational and Environmental Health, Kitakyushu, Japan

    Eisuke Katafuchi & Toshiyuki Nakayama

  5. Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Hiroshi Mukae

Authors
  1. Atsushi Sawase
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  2. Mineaki Kitamura
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  3. Misato Morimoto
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  4. Haruka Fukuda
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  9. Hiroshi Mukae
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  10. Tomoya Nishino
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Correspondence to Mineaki Kitamura.

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Sawase, A., Kitamura, M., Morimoto, M. et al. Renal tubular necrosis associated with anagrelide administration: a case report. CEN Case Rep (2024). https://doi.org/10.1007/s13730-024-00881-3

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  • DOI: https://doi.org/10.1007/s13730-024-00881-3

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