{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T15:56:56Z","timestamp":1792252616639,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,9,25]],"date-time":"2018-09-25T00:00:00Z","timestamp":1537833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Agents targeting vascular endothelial growth factor (<jats:styled-content style=\"fixed-case\">VEGF<\/jats:styled-content>) have increasingly been used for the treatment of advanced malignancies, and have been found to induce renal thrombotic microangiopathy (<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>) and proteinuria. However, histomorphological changes in human biopsies in this setting and the underlying mechanism are not yet fully understood. Therefore, we collected renal biopsy cases with a history of <jats:styled-content style=\"fixed-case\">aVEGF<\/jats:styled-content> therapy to review and compare morphological kidney changes in this context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Renal biopsies of 15 patients who had received anti\u2010<jats:styled-content style=\"fixed-case\">VEGF<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">aVEGF<\/jats:styled-content>) therapy evaluated between 2013 and 2017 at a single centre were morphologically characterised with light microscopy, electron microscopy, and immunohistochemistry (IgA, IgG, IgM, C1q, and C3), and compared with cases with acute <jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content> caused by atypical haemolytic\u2013uraemic syndrome or hypertension. Morphological overlap with immune complex and cryoglobulinaemic membranoproliferative glomerulonephritis, diabetic glomerulopathy and pre\u2010eclampsia\u2010induced glomerulopathy are discussed. Segmental glomerular capillary microaneurysms and segmental hyalinosis were typical morphological features of <jats:styled-content style=\"fixed-case\">aVEGF<\/jats:styled-content> therapy\u2010induced glomerular microangiopathy, whereas fibrin or platelet thrombi or fragmented erythrocytes were rarely found or were absent. <jats:styled-content style=\"fixed-case\">aVEGF<\/jats:styled-content> therapy\u2010associated microangiopathy was diffusely distributed in the glomeruli, spared preglomerular vessels, and showed morphological characteristics of chronic <jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>. In individual cases, <jats:styled-content style=\"fixed-case\">aVEGF<\/jats:styled-content> therapy\u2010induced glomerular microangiopathy was accompanied by immune\u2010complex glomerulonephritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">aVEGF<\/jats:styled-content> therapy\u2010induced glomerular microangiopathy has a characteristic morphology and clinical presentation that helps to differentiate it from other causes of <jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>. Awareness of these light microscopic findings allows identification of <jats:styled-content style=\"fixed-case\">aVEGF<\/jats:styled-content> therapy as a trigger of renal disease in critically ill cancer patients, and might therefore help in deciding on further therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13716","type":"journal-article","created":{"date-parts":[[2018,7,17]],"date-time":"2018-07-17T07:46:48Z","timestamp":1531813608000},"page":"990-1001","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Characteristic morphological changes in anti\u2010<scp>VEGF<\/scp> therapy\u2010induced glomerular microangiopathy"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9974-6683","authenticated-orcid":false,"given":"Frederick","family":"Pfister","sequence":"first","affiliation":[{"name":"Department of Nephropathology Institute of Pathology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg (FAU) Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Amann","sequence":"additional","affiliation":[{"name":"Department of Nephropathology Institute of Pathology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg (FAU) Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Nephropathology Institute of Pathology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg (FAU) Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Klewer","sequence":"additional","affiliation":[{"name":"Department of Nephropathology Institute of Pathology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg (FAU) Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"B\u00fcttner","sequence":"additional","affiliation":[{"name":"School of Psychology College of Life and Environmental Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maike","family":"B\u00fcttner\u2010Herold","sequence":"additional","affiliation":[{"name":"Department of Nephropathology Institute of Pathology Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg (FAU) Erlangen 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