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1例59岁女性肺癌患者应用安罗替尼（标准方案）2个周期后出现胸闷、气短、乏力、少尿，实验室检查示血肌酐995.5 μmol/L，尿素氮18.9 mmol/L，血尿酸637 μmol/L，24 h尿量400 ml，血钾3.63 mmol/L，丙氨酸转氨酶（ALT）518 U/L，天冬氨酸转氨酶（AST）32 U/L，总胆红素38.8 μmol/L，血小板计数45×10 9/L。诊断为急性肾衰竭、肝功能异常、血小板减少症。辅助检查结果排除基础疾病进展所致可能性。患者临床症状与口服安罗替尼存在时间相关性。停用该药并给予血液透析、保肝、利尿等对症治疗。14 d后，患者胸闷、气短、乏力明显缓解；实验室检查示血肌酐480.3 μmol/L，尿素氮16.2 mmol/L，血尿酸414 μmol/L，24 h尿量1 700 ml，血钾3.18 mmol/L，ALT 45 U/L，AST 31 U/L，总胆红素37.4 μmol/L，血小板计数81×10 9/L。

A 59-year-old female patient with lung cancer developed chest tightness, shortness of breath, fatigue, and oliguria after 2 cycles of anlotinib standard regimen. Laboratory tests showed serum creatinine 995.5 μmol/L, urea nitrogen 18.9 mmol/L, blood uric acid 637 μmol/L, 24-hour urine output 400 ml, blood potassium 3.63 mmol/L, alanine aminotransferase (ALT) 957 U/L, aspartate aminotransferase (AST) 32 U/L, total bilirubin 38.8 μmol/L, and platelet count 49×10 9/L. Acute renal failure, liver dysfunction, and thrombocytopenia was diagnosed. The auxiliary examination results excluded the possible progression of underlying diseases. The clinical manifestations of the patient were time-dependent with oral administration of anlotinib. Anlotinib was discontinued and symptomatic treatments such as hemodialysis, liver protection, and diuresis were given. After 14 days, chest tightness, shortness of breath, and fatigue were significantly relieved. Laboratory tests showed serum creatinine 480.3 μmol/L, urea nitrogen 16.2 mmol/L, blood uric acid 414 μmol/L, 24-hour urine output 1 700 ml, blood potassium 3.18 mmol/L, ALT 45 U/L, AST 31 U/L, total bilirubin 37.4 μmol/L, and platelet count 81×10 9/L.