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

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Citation: Journal of Oncology Pharmacy Practice. 25(4):1011-1015, 2019 Jun.PMID: 29768958Institution: MedStar Washington Hospital Center | Washington Cancer InstituteDepartment: Medicine/General Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Antibodies, Monoclonal, Humanized/tu [Therapeutic Use] | *Antineoplastic Agents, Immunological/ae [Adverse Effects] | *Atypical Hemolytic Uremic Syndrome/ci [Chemically Induced] | *Atypical Hemolytic Uremic Syndrome/dt [Drug Therapy] | *Bevacizumab/ae [Adverse Effects] | *Vascular Endothelial Growth Factor A/ai [Antagonists & Inhibitors] | Aged | Female | Humans | Middle AgedYear: 2019ISSN:
  • 1078-1552
Name of journal: Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy PractitionersAbstract: 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.All authors: Alhaj-Moustafa M, Fitzpatrick KW, Pilla R, Singh D, Vakiti AFiscal year: FY2019Fiscal year of original publication: FY2018Digital Object Identifier: ORCID: Date added to catalog: 2018-06-19
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Journal Article MedStar Authors Catalog Article 29768958 Available 29768958

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.

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