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Case Reports in Hematology
Volume 2016, Article ID 6020691, 5 pages
http://dx.doi.org/10.1155/2016/6020691
Case Report

Renal Thrombotic Microangiopathy Associated with the Use of Bortezomib in a Patient with Multiple Myeloma

1Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
2Hematology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
3Vascular Medicine and Hemostasis, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
4Pathology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
5Nephrology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium

Received 28 February 2016; Accepted 28 April 2016

Academic Editor: Marie-Christine Kyrtsonis

Copyright © 2016 Jan Van Keer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bortezomib is a first-generation proteasome inhibitor used in the treatment of multiple myeloma (MM). A few reports have linked bortezomib exposure with the development of thrombotic microangiopathy (TMA). We describe a case of biopsy-proven renal thrombotic microangiopathy associated with the use of bortezomib in a 51-year-old man with IgG lambda MM. To our knowledge, this is the first biopsy-proven case. In addition, reexposure to bortezomib 18 months later was associated with recurrence of TMA. This supports a possible causal role of bortezomib. The exact mechanisms remain to be elucidated.