ArticleInternal medicine (Tokyo, Japan)2025
Clinicopathological Study on Endothelial Injury in Severe Glomerular Microangiopathy Induced by Ramucirumab.
Article in Internal medicine (Tokyo, Japan), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
A patient with advanced colon cancer treated with ramucirumab, an anti-vascular endothelial growth factor receptor-2 agent developed nephrotic-range proteinuria and hypertension. A renal biopsy revealed hyaline occlusive glomerular microangiopathy with macrophage infiltration and focal podocyte swelling with hyperplasia. Furthermore, a circular fibrocellular crescent formation was observed. Anti-CD34 immunostaining indicated severe endothelial injury. Circulating syndecan-1, which is derived from the glycocalyx covering the endothelium, was moderately increased, similar to the plasma D-dimer level, but not as high as that in systemic endotheliopathy. This case suggests that severe kidney-specific endothelial injury may be responsible for the development of a unique extracapillary glomerulopathy as a side effect of ramucirumab.
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