Proteinuria in a patient receiving anti-VEGF therapy for metastatic renal cell carcinoma

被引：68
作者：
Roncone, Daniel
Satoskar, Anjali
Nadasdy, Tibor
Monk, J. Paul
Rovin, Brad H.
机构：
[1] Ohio State Univ, Div Nephrol, Coll Med, Columbus, OH 43210 USA
[2] Ohio State Univ, Renal Pathol Div, Coll Med, Columbus, OH 43210 USA
[3] Ohio State Univ, Div Hematol & Med Oncol, Coll Med, Columbus, OH 43210 USA
来源：
NATURE CLINICAL PRACTICE NEPHROLOGY | 2007年 / 3卷 / 05期
关键词：
anti-VEGF therapy; endothelial injury; proteinuria; renal cell carcinoma; thrombotic microangiopathy;
D O I：
10.1038/ncpneph0476
中图分类号：
R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];
学科分类号：
1002 ; 100201 ;
摘要：
Background A 59-year-old man who had undergone a left nephrectomy for renal cell carcinoma was found to have metastatic disease during a restaging examination. The patient was started on treatment with interferon a2b plus bevacizumab, a humanized monoclonal anti-vascular endothelial growth factor antibody. After 9 months of this therapy, the patient developed proteinuria, which gradually increased to over 6 g/day. Investigations Physical examination, urine and blood analysis, biopsy of the right kidney, and histologic evaluation of the non-neoplastic portion of the left nephrectomy specimen. Diagnosis Thrombotic microangiopathy and IgA immune-complex deposition in the glomerular capillary walls and mesangium. Management Discontinuation of interferon a2b and bevacizumab, control of blood pressure with an angiotensin-converting-enzyme inhibitor and an angiotensin-receptor blocker.
引用
收藏
页码：287 / 293
页数：7
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