QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Full Text PDF Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Articles Ahead of Print [Order Reprint] Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Barakat, R. K Articles by Foringer, J. R Search for Related Content PubMed PubMed Citation Articles by Barakat, R. K Articles by Foringer, J. R

Interstitial Nephritis Secondary to Bevacizumab Treatment in Metastatic Leiomyosarcoma

Clinical Fellow, Division of Renal Diseases and Hypertension, Medical School, The University of Texas–Houston, Houston, TX

Navneet Singh, MD

Clinical Fellow, Division of Renal Diseases and Hypertension, Medical School, The University of Texas–Houston

Rajiv Lal, MD

Clinical Fellow, Division of Renal Diseases and Hypertension, Medical School, The University of Texas–Houston

Regina R Verani, MD

Professor, Department of Pathology and Laboratory Medicine, Medical School, The University of Texas–Houston

Kevin W Finkel, MD

Associate Professor and Division Head, Renal Diseases and Hypertension, Medical School, The University of Texas–Houston

John R Foringer, MD

Assistant Professor and Fellowship Program Director, Renal Diseases and Hypertension, Medical School, The University of Texas–Houston

Reprints: Dr. Foringer, Renal Diseases and Hypertension, Medical School, The University of Texas–Houston, 6431 Fannin St., MSB 4.148, Houston, TX 77030, fax 713/500-6882, john.r.foringer{at}uth.tmc.edu

OBJECTIVE: To report a case of interstitial nephritis associated with the administration of bevacizumab.

CASE SUMMARY: A 26-year-old man diagnosed with metastatic rectal leiomyosarcoma was treated with intravenous bevacizumab 5 mg/kg and received a total of 3 doses at 2 week intervals. His creatinine had increased from 1.0 mg/dL at baseline to 1.6 mg/dL after 2 doses of bevacizumab and to 4.7 mg/dL after the third dose, prompting admission. Acute renal failure was diagnosed, and hemodialysis was initiated. A renal biopsy revealed interstitial nephritis. Renal failure resolved with cessation of the drug, and the patient did not require further hemodialysis.

DISCUSSION: Bevacizumab is a recombinant humanized monoclonal immunoglobulin G antibody to vascular endothelial growth factor. Bevacizumab has shown efficacy in treatment of patients with renal cell carcinoma and colorectal cancer and has been approved by the Food and Drug Administration as a first-line treatment for metastatic colorectal cancer. Our patient had no other confounding factors that might have caused renal failure. The presence of primary glomerular disease was excluded by biopsy. According to the Naranjo probability scale, bevacizumab was the probable cause of acute renal failure in this patient.

CONCLUSIONS: Bevacizumab can cause acute renal failure by inducing interstitial nephritis. Renal function should be monitored during bevacizumab therapy.

Key Words: acute renal failure, bevacizumab, interstitial nephritis

Published Online, March 20, 2007. www.theannals.com, DOI 10.1345/aph.1H635