Renal-limited thrombotic microangiopathy after switching from bevacizumab to ramucirumab: a case report.


Department of Nephrology, Shizuoka General Hospital, Shizuoka, 420-8527, Japan. [Email]


It is well known that vascular endothelial growth factor (VEGF) inhibitors can cause proteinuria. The incidence of proteinuria is high for bevacizumab, a humanized monoclonal antibody directed against VEGF, but the range of proteinuria rarely becomes nephrotic (2.2% occurrence according to a meta-analysis). In such cases, renal pathology shows thrombotic microangiopathy (TMA). Ramucirumab, anti-VEGF receptor 2 (VEGFR2) monoclonal antibody, can also cause proteinuria, but it is not yet reported whether the drug may induce TMA.


Bevacizumab,Nephrotic syndrome,Proteinuria,Ramucirumab,Thrombotic microangiopathy,