Bevacizumab-induced atypical hemolytic uremic syndrome and treatment with eculizumab.

Bevacizumab (Avastin) is a recombinant humanized monoclonal antibody used for the management of various solid malignancies including colorectal, lung, brain, renal, and ovarian cancers as well as age-related macular degeneration of the eye. It is a vascular endothelial growth factor inhibitor which exhibits its action by blocking the growth of blood vessels in cancerous tissue. Common side effects include hypertension, fatigue, headaches, and increased risk of infections. Atypical hemolytic uremic syndrome is a serious side effect associated with bevacizumab due to its anti-angiogenic effect. It encompasses the clinical triad of thrombocytopenia, microangiopathic hemolytic anemia, and acute renal failure, without any association with Shiga toxins. Eculizumab is a terminal complement inhibitor used in the treatment of atypical hemolytic uremic syndrome. Herein, we present three cases of bevacizumab-induced atypical hemolytic syndrome treated successfully with eculizumab.

Competing effects of rotational diffusivity and activity on finite-sized clusters.

Colloidal particles interacting via short-range attraction and long-range repulsion are known to stabilize finite-sized clusters under equilibrium conditions. In this work, the effect of self-propulsion speed (activity) and rotational diffusivity (Dr) on the phase behavior of such particles is investigated using Brownian dynamics simulations. The system exhibits rich phase behavior consisting of clusters of different kinds. The cluster size varies non-monotonically with activity: increasing first and decreasing at higher activity, thus driving cluster-to-fluid phase transition. Rotational diffusivity also facilitates the formation of clusters. Larger clusters could be stabilized at lowDrvalues while at highDrvalues, clusters are stable even at higher activities. The analysis of the static structure factor of the system confirms that rotational diffusivity delays the cluster-to-fluid transition driven by activity.

Ifosfamide-Induced Metabolic Encephalopathy in 2 Patients With Cutaneous T-Cell Lymphoma Successfully Treated With Methylene Blue.

Ifosfamide, an alkylating agent used in cancer treatments, can cause neurotoxicity. The clinical presentation can range from mild symptoms such as acute confusion to non-convulsive seizures, severe irreversible coma, and death. The benefit of methylene blue use in treating ifosfamide-induced metabolic encephalopathy is not well established. In this article, we present 2 cases of ifosfamide-induced metabolic encephalopathy responsive to methylene blue treatment.