Nephrotic Syndrome with Focal Segmental Glomerulosclerosis Induced by Intravitreal Injections of Vascular Endothelial Growth Factor Inhibitor

Intern Med. 2020 Dec 1;59(23):3051-3054. doi: 10.2169/internalmedicine.5410-20. Epub 2020 Jul 28.

Abstract

An 83-year-old woman with a 1-year history of scheduled intravitreal injection of vascular endothelial growth factor (VEGF) inhibitor (aflibercept) was diagnosed with nephrotic syndrome due to focal segmental glomerulosclerosis with histopathological findings of segmental infiltration of foam cells in the glomerular capillaries. Her nephrotic syndrome improved immediately following the termination of aflibercept intravitreal injection without steroid therapy. Although widely used to treat ophthalmic diseases, we should keep in mind that even intravitreal injection of VEGF inhibitor, as opposed to systemic administration, can cause kidney injury.

Keywords: VEGF inhibitor; aflibercept; podocyte; proteinuria.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angiogenesis Inhibitors / adverse effects*
  • Female
  • Glomerulosclerosis, Focal Segmental / etiology*
  • Humans
  • Intravitreal Injections
  • Kidney / pathology
  • Kidney Glomerulus / blood supply
  • Kidney Glomerulus / pathology
  • Receptors, Vascular Endothelial Growth Factor
  • Recombinant Fusion Proteins / adverse effects*

Substances

  • Angiogenesis Inhibitors
  • Recombinant Fusion Proteins
  • aflibercept
  • Receptors, Vascular Endothelial Growth Factor