ArticleFrontiers in medicine2025
Case Report: Gemcitabine-induced membranoproliferative glomerulonephritis with immune complexes in a patient with metastatic pancreatic cancer.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Gemcitabine is a widely used chemotherapeutic agent for pancreatic adenocarcinoma, that is associated with rare but serious renal complications including thrombotic microangiopathy (TMA). We report a unique case of biopsy-proven membranoproliferative glomerulonephritis (MPGN) with immune complex deposition in a woman receiving gemcitabine for metastatic pancreatic cancer. She developed new-onset hypertension, proteinuria, microscopic hematuria, and progressive renal dysfunction shortly following initiation of gemcitabine. Extensive autoimmune, complement, paraprotein, and viral serologies were unremarkable aside from a low haptoglobin. Kidney biopsy revealed an MPGN pattern with immune deposits. Gemcitabine was discontinued, and the patient was treated with corticosteroids and kidney-protective therapies targeting blood pressure and proteinuria reduction. Her proteinuria decreased significantly, and her renal function returned back to baseline. This case highlights a rare manifestation of gemcitabine-induced nephrotoxicity with immune complex MPGN, suggesting a possible novel mechanism of drug-associated glomerular injury.
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