Renal Implications of Long-Term Systemic Bevacizumab for Recurrent Respiratory Papillomatosis.
Ann Otol Rhinol Laryngol
; 133(1): 119-123, 2024 Jan.
Article
en En
| MEDLINE
| ID: mdl-37439024
ABSTRACT
BACKGROUND:
Bevacizumab is a vascular endothelial growth factor (VEGF) inhibitor that is used off-label for select cases of recurrent respiratory papillomatosis (RRP) that are severe, involve the distal airway or lung parenchyma, and refractory to other forms of adjuvant therapy. However, there is limited safety data for the use of bevacizumab in children and VEGF inhibitors are reported to have a range of adverse renal effects, including hypertension, proteinuria, and thrombotic microangiopathy (TMA). CASE-DIAGNOSIS/TREATMENT This report describes a case of severe juvenile-onset RRP that had an exceptionally high operative burden that was refractory to several adjuvant treatment strategies (including intralesional cidofovir and subcutaneous pegylated interferon). Bevacizumab treatment resulted in a dramatic and sustained improvement in disease control over a 5-year period. However, after 3 years of treatment, the patient developed hypertension and proteinuria and was found to have evidence of a glomerular TMA on kidney biopsy. These complications were successfully managed with a reduction in bevacizumab frequency and angiotensin-converting enzyme inhibitor initiation.CONCLUSIONS:
Clinicians caring for children treated with VEGF inhibitors should be aware of the potential renal complications and their management.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones por Papillomavirus
/
Hipertensión
Límite:
Child
/
Humans
Idioma:
En
Revista:
Ann Otol Rhinol Laryngol
Año:
2024
Tipo del documento:
Article
País de afiliación:
Canadá