A.R.R. has received a speaker’s fee from Eli Lilly that was not related to this case report. The remaining authors declare that they have no competing interests.
Analysis of patient’s clinical course and outcomes: JAN, NDAR, OUV, and ARR; drafting of the manuscript: JAN, NDAR, and RB; critical revision of the manuscript for important intellectual content: JAN and ARR; critical revision of kidney biopsy results and images: ARH. Administrative, technical, and material support: JAN, NDAR, ARH, and ARR. All authors read and approved the final manuscript.
Denosumab and abiraterone were approved by the United States Food and Drug Administration in 2011 for the treatment of metastatic castration-resistant prostate cancer. Neither denosumab nor abiraterone is known to cause rhabdomyolysis.
A 76-year-old Caucasian man with metastatic prostate cancer presented with non-oliguric severe acute kidney injury (AKI) 3 weeks after receiving simultaneous therapy with denosumab and abiraterone. The patient had been on statin therapy for more than 1 year with no recent dose adjustments. His physical exam was unremarkable. Blood work on admission revealed hyperkalemia, mild metabolic acidosis, hypocalcemia, and elevated creatine kinase (CK) at 44,476 IU/L. Kidney biopsy confirmed the diagnosis of rhabdomyolysis-induced AKI. The patient responded well to intravenous isotonic fluids and discontinuation of denosumab, abiraterone, and rosuvastatin, with normalization of CK and recovery of kidney function.
We report the first case of biopsy-proven rhabdomyolysis-induced AKI in a cancer patient acutely exposed to denosumab and abiraterone. Whether one of these drugs individually, or the combination, was the bona fide culprit of muscle breakdown is unknown. Nonetheless, our report is hypothesis-generating for further investigations on the effect of these drugs on muscle cells.
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- Rhabdomyolysis-induced acute kidney injury in a cancer patient exposed to denosumab and abiraterone: a case report
Javier A. Neyra
Natalia A. Rocha
Omkar U. Vaidya
Allen R. Hendricks
Aylin R. Rodan
- BioMed Central
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