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Published on: June 30, 2018
Anti-VEGF-related thrombotic microangiopathy in a child presenting with nephrotic syndrome
Songül Yılmaz1,2, Z Birsin Özçakar3, Aysel Taktak4
1Department of Pediatrics, Division of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey. songulyilmaz23@gmail.com.
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.
Insights
Vascular endothelial growth factor (VEGF) inhibitors can cause kidney problems like nephrotic syndrome. Discontinuing VEGF therapy can lead to spontaneous remission of these renal adverse effects.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Vascular endothelial growth factor (VEGF) signaling pathway is a key target in cancer therapy.
- Anti-VEGF therapies can cause renal adverse effects, including hypertension, proteinuria, and rarely nephrotic syndrome (NS) and acute kidney injury.
Observation:
- A 15-year-old male developed nephrotic syndrome and thrombotic microangiopathy 26 months after anti-VEGF therapy.
- The patient's nephrotic syndrome resolved spontaneously within 3 months of discontinuing the anti-VEGF treatment.
Findings:
- Anti-VEGF therapy can induce nephrotic syndrome and thrombotic microangiopathy.
- Early identification and cessation of anti-VEGF agents are crucial for managing these renal complications.
Implications:
- Nephrologists must be vigilant for renal side effects associated with anti-VEGF therapies.
- Prompt withdrawal of anti-VEGF agents can lead to favorable outcomes and spontaneous remission of nephrotic syndrome.
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