Abstract
Background:
Targeting the vascular endothelial growth factor (VEGF) signaling pathway has become an important approach to current cancer therapy. Anti-VEGF therapy-related renal adverse effects may present as hypertension, non-nephrotic proteinuria, and rarely as nephrotic syndrome (NS) and acute kidney injury.
Case-diagnosis/treatment:
In this report, we present a 15-year-old boy who had developed nephrotic syndrome and thrombotic microangiopathy 26 months after administration of anti-VEGF therapy. Treatment was discontinued and nephrotic syndrome remitted spontaneously within 3 months.
Conclusions:
Nephrologists should be aware of the side effects of anti-VEGF therapy. Early diagnosis and prompt management with withdrawal of the agents will result in spontaneous remission.
Keywords:
Anti-VEGF; Bevacizumab; Child; Nephrotic syndrome; Thrombotic microangiopathy.
MeSH terms
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Adolescent
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Angiogenesis Inhibitors / adverse effects*
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Angiogenesis Inhibitors / therapeutic use
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Antineoplastic Agents / adverse effects*
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Antineoplastic Agents / therapeutic use
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Antineoplastic Combined Chemotherapy Protocols / adverse effects*
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Bevacizumab / adverse effects
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Bevacizumab / therapeutic use
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Bone Neoplasms / drug therapy
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Cisplatin / therapeutic use
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Doxorubicin / therapeutic use
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Humans
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Ifosfamide / therapeutic use
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Male
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Methotrexate / therapeutic use
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Nephrotic Syndrome / chemically induced*
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Nephrotic Syndrome / diagnosis
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Niacinamide / adverse effects
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Niacinamide / analogs & derivatives
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Niacinamide / therapeutic use
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Osteosarcoma / drug therapy
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Phenylurea Compounds / adverse effects
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Phenylurea Compounds / therapeutic use
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Proteinuria / diagnosis
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Proteinuria / etiology
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Remission, Spontaneous
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Sorafenib
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Thrombotic Microangiopathies / chemically induced*
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Thrombotic Microangiopathies / diagnosis
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Vascular Endothelial Growth Factor A / antagonists & inhibitors*
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Withholding Treatment
Substances
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Angiogenesis Inhibitors
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Antineoplastic Agents
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Phenylurea Compounds
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Vascular Endothelial Growth Factor A
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Niacinamide
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Bevacizumab
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Doxorubicin
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Sorafenib
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Cisplatin
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Ifosfamide
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Methotrexate