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.