期刊
IMMUNOTHERAPY
卷 13, 期 4, 页码 283-288出版社
FUTURE MEDICINE LTD
DOI: 10.2217/imt-2020-0223
关键词
acute interstitial nephritis; acute kidney injury; ANCA; antineutrophil cytoplasmic antibody titer; immune checkpoint inhibitor; immunoassays; immunotherapy; immunotoxicity; pembrolizumab; proton pump inhibitor
类别
Renal toxicity from ICIs can present as acute interstitial nephritis with highly variable timing. This case study presents a male patient who developed grade 3 immune-related renal toxicity after reusing the same ICI, but improved after steroid treatment and discontinuation of the medication.
Renal toxicity from immune checkpoint inhibitors (ICIs) is an increasingly recognized cause of acute kidney injury among patients with cancer. ICI-associated acute kidney injuries typically present as acute interstitial nephritis and the timing of onset is highly variable. Herein, we present a case of a patient with relapsed metastatic melanoma previously treated with pembrolizumab who developed grade 3 immune-related renal toxicity after reintroduction of the same ICI, secondary to acute interstitial nephritis with accompanying high PR3-antineutrophil cytoplasmic antibody titer. The patient improved after steroid treatment and discontinuation of pembrolizumab. This case highlights the importance of not excluding ICI-related nephrotoxicity as a possible cause of renal failure, including in those who previously tolerated ICI treatment, since it is a treatable entity.
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