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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