{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:36:52Z","timestamp":1787647012447,"version":"build-2736575974"},"reference-count":22,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Bevacizumab is a vascular endothelial growth factor (VEGF) inhibitor that is used off-label for select cases of recurrent respiratory papillomatosis (RRP) that are severe, involve the distal airway or lung parenchyma, and refractory to other forms of adjuvant therapy. However, there is limited safety data for the use of bevacizumab in children and VEGF inhibitors are reported to have a range of adverse renal effects, including hypertension, proteinuria, and thrombotic microangiopathy (TMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case-Diagnosis\/Treatment:<\/jats:title>\n                    <jats:p>This report describes a case of severe juvenile-onset RRP that had an exceptionally high operative burden that was refractory to several adjuvant treatment strategies (including intralesional cidofovir and subcutaneous pegylated interferon). Bevacizumab treatment resulted in a dramatic and sustained improvement in disease control over a 5-year period. However, after 3\u2009years of treatment, the patient developed hypertension and proteinuria and was found to have evidence of a glomerular TMA on kidney biopsy. These complications were successfully managed with a reduction in bevacizumab frequency and angiotensin-converting enzyme inhibitor initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Clinicians caring for children treated with VEGF inhibitors should be aware of the potential renal complications and their management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894231184942","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T02:26:28Z","timestamp":1689215188000},"page":"119-123","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Renal Implications of Long-Term Systemic Bevacizumab for Recurrent Respiratory Papillomatosis"],"prefix":"10.1177","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2223-0646","authenticated-orcid":false,"given":"Cal H.","family":"Robinson","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hart-Matyas","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Morgenstern","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damien","family":"Noone","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2750-8117","authenticated-orcid":false,"given":"Paolo","family":"Campisi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head & Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"key":"bibr1-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1177\/000348940511400407"},{"issue":"11","key":"bibr2-00034894231184942","first-page":"3953","volume":"31","author":"de Pasquale MD","year":"2011","journal-title":"Anticancer Res"},{"key":"bibr3-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29351"},{"issue":"6","key":"bibr4-00034894231184942","first-page":"267","volume":"70","author":"den Deurwaarder ES","year":"2012","journal-title":"Neth J Med"},{"key":"bibr5-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000207"},{"key":"bibr6-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/143426"},{"key":"bibr7-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1093\/ndtplus\/sfp175"},{"key":"bibr8-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2008.256"},{"key":"bibr9-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2014-0330"},{"key":"bibr10-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29343"},{"key":"bibr11-00034894231184942","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2014.2486"},{"key":"bibr12-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26662"},{"key":"bibr13-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010020167"},{"key":"bibr14-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00621.x"},{"key":"bibr15-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9440(10)61731-2"},{"key":"bibr16-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1172\/JCI17423"},{"key":"bibr17-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707330"},{"key":"bibr18-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603813"},{"key":"bibr19-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9440(10)63273-7"},{"key":"bibr20-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2009.11.001"},{"key":"bibr21-00034894231184942","doi-asserted-by":"publisher","DOI":"10.1177\/1078155218774895"},{"key":"bibr22-00034894231184942","doi-asserted-by":"publisher","DOI":"10.5414\/CN110443"}],"container-title":["Annals of Otology, Rhinology &amp; 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