Sunitinib-associated thrombotic microangiopathy: A significant risk

摘要

Thrombotic microangiopathy (TMA) is a rare but potentially fatal condition that must be urgently recognised and treated. A range of drugs has been reported to have precipitated TMA via uncertain or undetermined mechanisms. Sunitinib-induced TMA has been reported post-marketing, with four cases previously published worldwide [1—4] and only two cases reported to Medicines and Healthcare products Regulatory Authority (MHRA, the drug regulatory authority for the United Kingdom) to date in the UK. However, we have noted two cases in our hospital in recent months, associated with variable clinical severity. One case presented with a seizure, microangiopathic hae-molytic anaemia and renal impairment and was treated with plasma exchange. The other case was mildly affected and responded to drug withdrawal.