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Moll et al. w1x recently published a case report on the development of thrombotic microangiopathy after irradiation in ovarian malignancy. We would like to report our case of radiation nephropathy developing after`internal' radiotherapy in a female patient with metastatic medullary carcinoma. Radiation nephritis is an in¯ammatory and degenerative disease of the kidneys after exposure to radioactive substances or body irradiation. Technical development, increasing knowledge of the adverse effects of radiation, and implementation of preventive measures have reduced its incidence during the last decades. However, recent therapeutic advances in oncology (such as administration of radiometal-labelled peptide conjugates or combined high dose chemotherapy and radiation therapy in stem cell transplantation) increase nephrotoxicity. As demonstrated in our patient, the treatment with radioactive substances speci®cally bound to tumour-selective cell receptors (i.e. somatostatin receptors in metastatic medullary thyroid carcinoma) caused thrombotic microangiopathy that led to end-stage radiation nephropathy after 8 months. Case. A 63-year-old Caucasian female patient was admitted to our hospital in May 1999 for progressive weakness and newly diagnosed arterial hypertension. Blood tests revealed normochromic, normocytic anaemia (haemoglobin 8.0 gudl

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