title: Reversible skeletal changes after treatment with bevacizumab in a child with cutaneovisceral angiomatosis with thrombocytopenia syndrome.
abstract: Cutaneovisceral angiomatosis with thrombocytopenia (CAT) syndrome is a rare vascular disorder of the skin and gastrointestinal tract for which there is no standard treatment. We present a case in which a child with CAT syndrome was treated with bevacizumab, a vascular endothelial growth factor inhibitor, and subsequently developed asymptomatic metaphyseal bone lesions. Though not previously described as a side effect, we hypothesize that the use of bevacizumab in a child with active epiphyseal growth plates caused these radiographic lesions. Because of the potential for altered bone growth and metabolism, children receiving VEGF inhibitors should be monitored closely for bony toxicity.
authors.affiliation: Department of Pediatric Hematology/Oncology/Blood and Marrow Transplantation, University of Minnesota, MMC 484, 420 Delaware Street SE, Minneapolis, Minnesota 55455, USA. smith719@umn.edu
authors.forename: Angela R
authors.initials: AR
authors.lastname: Smith
authors.forename: Jane M
authors.initials: JM
authors.lastname: Hennessy
authors.forename: Margaret A Heisel
authors.initials: MA
authors.lastname: Kurth
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Nelson
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000798:Angiomatosis / Q000150:complications / Q000188:drug therapy*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001847:Bone Diseases / Q000139:chemically induced; D006801:Humans; D007223:Infant; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab