Internal medicine
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Alport syndrome is an inherited disorder characterized by progressive renal failure, sensorineural hearing loss, and ocular involvement due to pathogenic variants of genes encoding type IV collagen. A renal biopsy does not reveal specific findings in the early stages; thus, Alport syndrome may be diagnosed as another glomerular disease. We herein report two families that were previously diagnosed with other glomerular diseases based on renal biopsies and were then accurately diagnosed by genetic testing. An early diagnosis may lead to the avoidance of unnecessary biopsies and treatments, and appropriate management may improve the renal prognosis.
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We herein report a 68-year-old man with advanced non-small-cell lung cancer treated with tepotinib who showed marked general edema, hypoalbuminemia, and an elevated serum creatinine level. Although tepotinib-induced kidney injury due to creatinine transporter inhibition has been reported, renal biopsy findings suggested tubulointerstitial injury due to decreased renal blood flow, likely secondary to refractory fluid retention. This case highlights the potential for true kidney injury during tepotinib therapy and underscores the importance of careful monitoring and management of adverse renal effects.