TY - JOUR T1 - A case of ramucirumab-induced renal failure with nephrotic-range proteinuria and its pathological findings JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-239603 VL - 14 IS - 3 SP - e239603 AU - Yuta Nakano AU - Jiro Kumagai AU - Kiyotaka Nagahama AU - Hajime Fujisawa Y1 - 2021/03/01 UR - http://casereports.bmj.com/content/14/3/e239603.abstract N2 - Ramucirumab-induced renal dysfunction is rarely reported. The pathology of ramucirumab-associated nephropathy in past reports primarily shows thrombotic microangiopathy (TMA) lesions but podocytopathy is not yet known. We report a case of kidney injury induced by ramucirumab in a 71-year-old man with cecal cancer. He was referred to our department for increasing serum creatinine (Cr) levels from 1.08 mg/dL to 2.56 mg/dL after changing anticancer drugs from bevacizumab to ramucirumab. He showed nephrotic-range proteinuria (12.1 g/gCr). A renal biopsy revealed endothelial cell injuries, such as TMA and podocytopathy with epithelial cell hyperplasia, which looked like a crescent. After discontinuing ramucirumab, his renal function and proteinuria improved, as seen by his Cr levels and proteinuria which decreased to 1.74 mg/dL and 1.21 g/gCr, respectively, in 3 months. Unlike previous reports, we found that ramucirumab caused podocyte injuries. ER -