Everolimus-Associated Thrombotic Microangiopathy and Acute Kidney Injury in a Patient with Breast Cancer

Thrombotic microangiopathy is a pathological condition caused by several factors including drugs, and characterized by endothelial injury and small vessel occlusion. It may cause severe acute kidney injury. Everolimus, a mammalian target of Rapamycin inhibitor, is a macrolide antibiotic widely used in clinical conditions because of its anticancer and immunosuppressive effects. Recently it has been approved for use in breast cancer at a dose of 10 mg/day in combination with exemestane, an aromatase inhibitor. In the literature a few cases of everolimus-induced thrombotic microangiopathy and acute kidney injury in breast cancer patients have been reported. Here we reported the management of a breast cancer patient with everolimus-induced thrombotic microangiopathy and severe acute kidney injury with emphasis on close monitoring of kidney functions

Ticagrelor Use may Increase the Risk of Atorvastatin-Related Rhabdomyolysis

Ticagrelor is an antiplatelet aggregation inhibitor used after acute coronary syndrome. It is metabolized by the cytochrome P450 enzyme system in the liver, like the statins. Using these two agents together may result in rhabdomyolysis because of the rising serum atorvastatin level. Due to the increasing use of ticagrelor in the recent period, rhabdomyolysis has been seen as a side effect. We present a case of severe rhabdomyolysis possibly due to increased level of atorvastatin, in a patient using ticagrelor