{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:19:17Z","timestamp":1763356757437,"version":"3.45.0"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3389\/fmed.2025.1666859","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:16:34Z","timestamp":1763356594000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Gemcitabine-induced membranoproliferative glomerulonephritis with immune complexes in a patient with metastatic pancreatic cancer"],"prefix":"10.3389","volume":"12","author":[{"given":"Ahmed","family":"Abdelhakeem","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyle","family":"Baker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md. Shahrier","family":"Amin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani","family":"Babiker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nabeel","family":"Aslam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umair","family":"Majeed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1016\/S1470-2045(07)70203-6","article-title":"Gemcitabine-associated thrombotic thrombocytopenic purpura","volume":"8","author":"Zupancic","year":"2007","journal-title":"Lancet Oncol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2664","DOI":"10.1002\/cncr.20290","article-title":"Gemcitabine-associated thrombotic microangiopathy","volume":"100","author":"Humphreys","year":"2004","journal-title":"Cancer"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.1093\/jnci\/91.20.1779","article-title":"Membranoproliferative glomerulonephritis following gemcitabine and Vinorelbine chemotherapy for peritoneal mesothelioma","volume":"91","author":"Fracasso","year":"1999","journal-title":"JNCI J Natl Cancer Inst"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1093\/ndt\/13.4.1050b","article-title":"A case of membranous glomerulonephritis associated with adenocarcinoma of pancreas","volume":"13","author":"Helin","year":"1998","journal-title":"Nephrol Dial Transplant"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"130","DOI":"10.5414\/CNP71130","article-title":"Gemcitabine nephrotoxicity and hemolytic uremic syndrome: report of 29 cases from a single institution","volume":"71","author":"Glezerman","year":"2009","journal-title":"Clin Nephrol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1093\/ndt\/gfac098.002","article-title":"FC019: parietal epithelial cells activation during gemcitabine-induced nephrotoxicity: communication with endothelial cells?","volume":"37","author":"Ben Ali","year":"2022","journal-title":"Nephrol Dial Transplant"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/S0959-8049(97)00354-7","article-title":"Effects of gemcitabine on renal function in patients with non-small cell lung cancer","volume":"34","author":"Gietema","year":"1998","journal-title":"Eur J Cancer"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.krcp.2015.06.001","article-title":"A case of gemcitabine-induced thrombotic microangiopathy in a urothelial tumor patient with a single kidney","volume":"34","author":"Ryu","year":"2015","journal-title":"Kidney Res Clin Pract"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.2215\/CJN.01910215","article-title":"Drug-induced glomerular disease: immune-mediated injury","volume":"10","author":"Hogan","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e9231","DOI":"10.1002\/ccr3.9231","article-title":"Full-house nephropathy in antinuclear antibody-negative systemic lupus erythematosus: a case report","volume":"12","author":"Dhungana","year":"2024","journal-title":"Clin Case Rep"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1666859\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:16:35Z","timestamp":1763356595000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1666859\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,17]]},"references-count":10,"alternative-id":["10.3389\/fmed.2025.1666859"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1666859","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,17]]},"article-number":"1666859"}}