Abstract
We present a patient with metastatic renal cell carcinoma treated with sunitinib, a multitargeted tyrosine kinase inhibitor. The patient experienced bilateral blue toe syndrome which we related to sunitinib use. Discontinuation of sunitinib to lower the patient's prothrombotic state and increase the ability to form collaterals, together with the addition of low-molecular-weight heparin to treat the occluding thrombi, resulted in waning of the blue toe syndrome. This case adds to the accumulating evidence of possible untoward cardiovascular side effects that should be taken into consideration in patients on tyrosine kinase inhibitors such as sunitinib.
MeSH terms
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Antineoplastic Agents / adverse effects*
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Antineoplastic Agents / therapeutic use
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Blue Toe Syndrome / chemically induced*
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Blue Toe Syndrome / pathology
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Carcinoma, Renal Cell / drug therapy*
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Carcinoma, Renal Cell / pathology
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Heparin, Low-Molecular-Weight / therapeutic use
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Humans
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Indoles / adverse effects*
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Indoles / therapeutic use
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Kidney Neoplasms / drug therapy*
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Kidney Neoplasms / pathology
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Male
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Middle Aged
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Neoplasm Metastasis
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Protein Kinase Inhibitors / adverse effects
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Protein Kinase Inhibitors / therapeutic use
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Pyrroles / adverse effects*
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Pyrroles / therapeutic use
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Sunitinib
Substances
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Antineoplastic Agents
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Heparin, Low-Molecular-Weight
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Indoles
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Protein Kinase Inhibitors
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Pyrroles
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Sunitinib