Journal of Advanced Intensive and Critical Care Medicine

Abstract

Aim and Background: Sunitinib, a tyrosine kinase inhibitor, is commonly used for advanced renal cell carcinoma (RCC) but is associated with significant adverse effects. This report aims to highlight a rare case of accelerated hypertension, acute pulmonary edema, and cutaneous vasculitis leading to gangrene caused by Sunitinib.

Case Description: A 69-year-old male with metastatic RCC presented with acute breathlessness, se vere hypertension, and a gangrenous ulcer on the right great toe after six months of Sunitinib therapy. His medical history included chronic kidney disease, diabetes mellitus, and systemic hypertension. Investigations revealed anemia, thrombocytopenia, renal impairment, and cutaneous vasculitis. As all thesigns and symptoms could also be attributed to use of Sunitinib, it was discontinued, and the patient was treated with non-invasive ventilation, hemodialysis, and supportive care, resulting in clinical stabilization.

Conclusion: This case demonstrates a rare but significant complication of Sunitinib therapy. The timely cessation of the drug and appropriate supportive care were crucial in improving the patient’s condition.

Clinical Significance: Clinicians must remain vigilant for severe adverse effects in patients on Sunitinib, particularly those with pre-existing comorbidities. Regular monitoring and patient education are essential for the early detection and management of complications, ensuring better treatment outcomes.