nach oben

Erschienen in:

29.02.2016 | Brief Report

Anti-VEGF-related thrombotic microangiopathy in a child presenting with nephrotic syndrome

verfasst von: Songül Yılmaz, Z. Birsin Özçakar, Aysel Taktak, Saba Kiremitçi, Arzu Ensari, Handan Dinçaslan, Fatoş Yalçınkaya

Erschienen in: Pediatric Nephrology | Ausgabe 6/2016

Einloggen, um Zugang zu erhalten

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.

Ellis LM, Hicklin DJ (2008) VEGF-targeted therapy: mechanisms of anti-tumour activity. Nat Rev Cancer 8:579–591CrossRefPubMed

Kubota Y (2012) Tumour angiogenesis and anti-angiogenic therapy. Keio J Med 61:47–56CrossRefPubMed

Eremina V, Jefferson JA, Kowalewska J, Hochster H, Haas M, Weisstuch J, Richardson C, Kopp JB, Kabir MG, Backx PH, Gerber HP, Ferrara N, Barisoni L, Alpers CE, Quaggin SE (2008) VEGF inhibition and renal thrombotic microangiopathy. N Engl J Med 358:1129–1136CrossRefPubMedPubMedCentral

Izzedine H, Rixe O, Billemont B, Baumelou A, Deray G (2007) Angiogenesis inhibitor therapies: focus on kidney toxicity and hypertension. Am J Kidney Dis 50:203–218CrossRefPubMed

Yang JC, Haworth L, Sherry RM, Hwu P, Schwartzentruber DJ, Topalian SL, Steinberg SM, Chen HX, Rosenberg SA (2003) A randomized trial of bevacizumab, an antivascular endothelial growth factor antibody, for metastatic renal cancer. N Engl J Med 349:427–434CrossRefPubMedPubMedCentral

Wu S, Kim C, Baer L, Zhu X (2010) Bevacizumab increases risk for severe proteinuria in cancer patients. J Am Soc Nephrol 21:1381–1389CrossRefPubMedPubMedCentral

Ollero M, Sahali D (2015) Inhibition of the VEGF signalling pathway and glomerular disorders. Nephrol Dial Transplant 30:1449–1455CrossRefPubMed

Roskoski R Jr (2007) Vascular endothelial growth factor (VEGF) signaling in tumor progression. Crit Rev Oncol Hematol 62:179–213CrossRefPubMed

Müller-Deile J, Worthmann K, Saleem M, Tossidou I, Haller H, Schiffer M (2009) The balance of autocrine VEGF-A and VEGF-C determines podocyte survival. Am J Physiol Renal Physiol 297:1656–1667CrossRef

10.

Wilhelm SM, Adnane L, Newell P, Villanueva A, Llovet JM, Lynch M (2008) Preclinical overview of sorafenib, a multikinase inhibitor that targets both Raf and VEGF and PDGF receptor tyrosine kinase signaling. Mol Cancer Ther 7:3129–3140CrossRefPubMed

11.

Eramina V, Quaggin SE (2004) The role of VEGF-A in glomerular development and function. Curr Opin Nephrol Hypertens 13:9–15CrossRef

12.

Fangusaro J, Gururangan S, Poussaint TY, McLendon RE, Onar-Thomas A, Warren KE, Wu S, Packer RJ, Banerjee A, Gilbertson RJ, Jakacki R, Gajjar A, Goldman S, Pollack IF, Friedman HS, Boyett JM, Kun LE, Fouladi M (2013) Bevacizumab (BVZ)-associated toxicities in children with recurrent central nervous system tumors treated with BVZ and irinotecan (CPT-11): a pediatric brain tumor consortium study (PBTC-022). Cancer 119:4180–4187CrossRefPubMed

13.

Izzedine H, Massard C, Spano JP, Goldwasser F, Khayat D, Soria JC (2010) VEGF signalling inhibition-induced proteinuria: mechanisms, significance and management. Eur J Cancer 46:439–448CrossRefPubMed

14.

Izzedine H, Mangier M, Ory V, Zhang SY, Sendeyo K, Bouachi K, Audard V, Péchoux C, Soria JC, Massard C, Bahleda R, Bourry E, Khayat D, Baumelou A, Lang P, Ollero M, Pawlak A, Sahali D (2014) Expression patterns of RelA and cmip are associated with different glomerular diseases following anti-VEGF therapy. Kidney Int 85:457–470CrossRefPubMed

15.

Azad NS, Psoadas EM, Kwitkoski VE, Steinberg SM, Jain L, Annunziata CM, Minasian L, Sarosy G, Kods HL, Premkumar A, Cao L, Mecnally D, Chow C, Chen HX, Wright JJ, Figg WD, Kohn EC (2008) Combination targeted therapy with sorafenib and bevacizumab results in enhanced toxicity and antitumor activity. J Clin Oncol 26:3709–3714CrossRefPubMed

Titel: Anti-VEGF-related thrombotic microangiopathy in a child presenting with nephrotic syndrome
verfasst von: Songül Yılmaz
Z. Birsin Özçakar
Aysel Taktak
Saba Kiremitçi
Arzu Ensari
Handan Dinçaslan
Fatoş Yalçınkaya
Publikationsdatum: 29.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 6/2016
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-016-3355-z

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Anti-VEGF-related thrombotic microangiopathy in a child presenting with nephrotic syndrome