PMID- 32378178
OWN - NLM
STAT- MEDLINE
DCOM- 20210906
LR  - 20221207
IS  - 2192-4449 (Electronic)
IS  - 2192-4449 (Linking)
VI  - 9
IP  - 4
DP  - 2020 Nov
TI  - Rapidly progressive glomerulonephritis caused by tegafur/gimeracil/oteracil 
      resulted in diabetes nephropathy, in a patient with minor risk of diabetes 
      nephropathy: a case report.
PG  - 347-353
LID - 10.1007/s13730-020-00485-7 [doi]
AB  - A 79-year-old Japanese male with a history of type 2 diabetes mellitus (T2DM) for 
      16 years was admitted to evaluate possible renal disease. The T2DM was well 
      controlled in this patient using nutrition therapy without the need for any 
      diabetes medication, and both diabetes retinopathy and proteinuria were negative. 
      At the age of 78 advanced colorectal cancer (stage IIIa) was diagnosed and 
      laparoscopic-assisted colectomy was performed. Following this procedure, the 
      patient began treatment with tegafur/gimeracil/oteracil (S-1), 80 mg twice daily 
      for 28 days of 42-day cycle. The patient received S-1 for 6 months, during which 
      time, serum albumin decreased from 3.0 g/dL to 1.1 g/dL, urinary protein 
      increased from negative to 3.0 g/day, and serum creatinine increased from 
      0.9 mg/dL to 2.1 mg/dL. Treatment with S-1 was discontinued, and furosemide 
      180 mg and prednisolone 30 mg treatment was initiated; however, serum creatinine 
      levels continued to increase to 7.2 mg/dL and proteinuria continued to increase 
      reaching a nephrotic range. A disintegrin and metalloproteinase with a 
      thrombospondin type 1 motif, member 13 (ADAMTS13) activity was decreased to 
      27.0%. Renal biopsy showed Kimmelstiel-Wilson nodules, while immunofluorescence 
      intensity of IgG subclass was IgG1 dominant, which was not compatible with 
      diabetic nephropathy (DN). Plasma exchange was not affected. However, 
      hemodialysis was initiated.The results of this investigation suggest that when 
      S-1 monotherapy is performed in the case with DN, rapidly progressive 
      glomerulonephritis (RPGN) may develop due to a condition similar to thrombotic 
      microangiopathy, even in patients with a minor risk factor of DN.
FAU - Toriu, Naoya
AU  - Toriu N
AUID- ORCID: 0000-0002-3712-6331
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan. ntoriu@kuhp.kyoto-u.ac.jp.
FAU - Sawa, Naoki
AU  - Sawa N
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Imafuku, Aya
AU  - Imafuku A
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Hasegawa, Eiko
AU  - Hasegawa E
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Sekine, Akinari
AU  - Sekine A
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Mizuno, Hiroki
AU  - Mizuno H
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Yamanouchi, Masayuki
AU  - Yamanouchi M
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Hiramatsu, Rikako
AU  - Hiramatsu R
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Hayami, Noriko
AU  - Hayami N
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Hoshino, Junichi
AU  - Hoshino J
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Kawada, Masahiro
AU  - Kawada M
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Suwabe, Tatsuya
AU  - Suwabe T
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan.
FAU - Ohashi, Kenichi
AU  - Ohashi K
AD  - Department of Pathology, Toranomon Hospital, Tokyo, Japan.
AD  - Department of Pathology, Graduate School of Medicine, Yokohama City University, 
      Yokohama, Japan.
FAU - Fujii, Takeshi
AU  - Fujii T
AD  - Department of Pathology, Toranomon Hospital, Tokyo, Japan.
FAU - Ubara, Yoshifumi
AU  - Ubara Y
AD  - Nephrology Center and Department of Rheumatology, Toranomon Hospital Kajigaya, 
      1-3-1, Takatsu, Kawasaki, Kanagawa, 212-0015, Japan. ubara@toranomon.gr.jp.
AD  - Okinaka Memorial Institute for Medical Research, Tokyo, Japan. 
      ubara@toranomon.gr.jp.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20200507
PL  - Japan
TA  - CEN Case Rep
JT  - CEN case reports
JID - 101636244
RN  - 0 (Drug Combinations)
RN  - 0 (Pyridines)
RN  - 0 (Serum Albumin)
RN  - 0 (tegafur-gimeracil-oteracil)
RN  - 150863-82-4 (S 1 (combination))
RN  - 1548R74NSZ (Tegafur)
RN  - 5VT6420TIG (Oxonic Acid)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Aged
MH  - Asian People/ethnology
MH  - Biopsy
MH  - Colorectal Neoplasms/drug therapy/pathology/surgery
MH  - Creatinine/blood
MH  - Diabetic Nephropathies/diagnosis/*etiology/therapy
MH  - Disease Progression
MH  - Drug Combinations
MH  - Glomerulonephritis/*chemically induced/complications
MH  - Humans
MH  - Kidney/pathology
MH  - Male
MH  - Neoplasm Staging
MH  - Oxonic Acid/*adverse effects/therapeutic use
MH  - Proteinuria/diagnosis
MH  - Pyridines/*adverse effects/therapeutic use
MH  - Renal Dialysis/methods
MH  - Risk Assessment
MH  - Serum Albumin/analysis
MH  - Tegafur/*adverse effects/therapeutic use
MH  - Withholding Treatment
PMC - PMC7502105
OTO - NOTNLM
OT  - Colorectal cancer
OT  - Diabetes glomerulopathy
OT  - Nephropathy
OT  - S-1
OT  - Thrombotic microangiopathy
COIS- All the authors declare no competing financial interests and no conflicts of 
      interest.
EDAT- 2020/05/08 06:00
MHDA- 2021/09/07 06:00
PMCR- 2020/05/07
CRDT- 2020/05/08 06:00
PHST- 2020/01/14 00:00 [received]
PHST- 2020/04/23 00:00 [accepted]
PHST- 2020/05/08 06:00 [pubmed]
PHST- 2021/09/07 06:00 [medline]
PHST- 2020/05/08 06:00 [entrez]
PHST- 2020/05/07 00:00 [pmc-release]
AID - 10.1007/s13730-020-00485-7 [pii]
AID - 485 [pii]
AID - 10.1007/s13730-020-00485-7 [doi]
PST - ppublish
SO  - CEN Case Rep. 2020 Nov;9(4):347-353. doi: 10.1007/s13730-020-00485-7. Epub 2020 
      May 7.