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

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.

• Authors: Naoya Toriu, Akinari Sekine, Hiroki Mizuno, Eiko Hasegawa, Masayuki Yamanouchi, Rikako Hiramatsu, Noriko Hayami, Junichi Hoshino, Masahiro Kawada, Tatsuya Suwabe, Keiichi Sumida, Naoki Sawa, Kenmei Takaichi, Kenichi Ohashi, Takeshi Fujii, Shuichiro Matoba, Yoshifumi Ubara
• Journal: Case reports in oncology (Case Rep Oncol) 2019 May-Aug Vol. 12 Issue 2 Pg. 391-400 ISSN: 1662-6575 [Print] Switzerland
• PMID: 31244641 (Publication Type: Case Reports)