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Renal-Limited Thrombotic Microangiopathy due to Bevacizumab Therapy for Metastatic Colorectal Cancer: A Case Report

Authors
  • Toriu, Naoya
  • Sekine, Akinari
  • Mizuno, Hiroki
  • Hasegawa, Eiko
  • Yamanouchi, Masayuki
  • Hiramatsu, Rikako
  • Hayami, Noriko
  • Hoshino, Junichi
  • Kawada, Masahiro
  • Suwabe, Tatsuya
  • Sumida, Keiichi
  • Sawa, Naoki
  • Takaichi, Kenmei
  • Ohashi, Kenichi
  • Fujii, Takeshi
  • Matoba, Shuichiro
  • Ubara, Yoshifumi
Type
Published Article
Journal
Case Reports in Oncology
Publisher
S. Karger AG
Publication Date
Jun 04, 2019
Volume
12
Issue
2
Pages
391–400
Identifiers
DOI: 10.1159/000500716
PMID: 31244641
PMCID: PMC6587198
Source
Karger
Keywords
License
Green
External links

Abstract

An 88-year-old Japanese man received bevacizumab for colorectal cancer with liver and peritoneal metastasis, during which nephrotic range proteinuria occurred (7.66 g/day). Renal biopsy showed endothelial damage with subendothelial swelling and a double contour of the glomerular basement membrane, which indicated a diagnosis of thrombotic microangiopathy (TMA). After bevacizumab was stopped, proteinuria decreased to 1 g/day. During the clinical course, this patient had no extrarenal manifestations. This case suggests that renal injury induced by bevacizumab is characterized by nephrotic range proteinuria and histological TMA, and is a renal-limited condition that differs from systemic TMA related to thrombotic thrombocytopenic purpura.

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