Two acute kidney injury episodes after ICI therapy: a case report.

IF 1 Q4 UROLOGY & NEPHROLOGY

CEN Case Reports Pub Date : 2024-10-01 Epub Date: 2024-03-07 DOI:10.1007/s13730-024-00855-5

Kohei Ishiga, Ryu Kobayashi, Tomohiko Kanaoka, Jotaro Harada, Ikuma Kato, Satoshi Fujii, Hiromichi Wakui, Yoshiyuki Toya, Kouichi Tamura

{"title":"Two acute kidney injury episodes after ICI therapy: a case report.","authors":"Kohei Ishiga, Ryu Kobayashi, Tomohiko Kanaoka, Jotaro Harada, Ikuma Kato, Satoshi Fujii, Hiromichi Wakui, Yoshiyuki Toya, Kouichi Tamura","doi":"10.1007/s13730-024-00855-5","DOIUrl":null,"url":null,"abstract":"<p><p>A 74-year-old Japanese male with lung squamous cell carcinoma received his first dose of immune checkpoint inhibitors (ICIs): ipilimumab and nivolumab. He developed acute kidney injury (AKI) and was admitted to our department. We diagnosed kidney immune-related adverse effects (irAE), and a kidney biopsy revealed acute tubulointerstitial nephritis. We started oral prednisolone (PSL) and his AKI immediately improved. The patient maintained stable findings after PSL was tapered off. However, seven months after the ICI administration, he developed rapid progressive glomerular nephritis and was admitted to our department again. The second kidney biopsy showed findings consistent with anti-glomerular basement membrane glomerulonephritis. Although the patient was treated with pulse methylprednisolone followed by oral PSL and plasma exchange, he became dependent on maintenance hemodialysis. To our knowledge, no case report has described two different types of biopsy-proven nephritis. In cases of suspected relapsing kidney irAEs, both a relapse of previous nephritis and the development of another type of nephritis should be considered.</p>","PeriodicalId":9697,"journal":{"name":"CEN Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444024/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CEN Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13730-024-00855-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/7 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

A 74-year-old Japanese male with lung squamous cell carcinoma received his first dose of immune checkpoint inhibitors (ICIs): ipilimumab and nivolumab. He developed acute kidney injury (AKI) and was admitted to our department. We diagnosed kidney immune-related adverse effects (irAE), and a kidney biopsy revealed acute tubulointerstitial nephritis. We started oral prednisolone (PSL) and his AKI immediately improved. The patient maintained stable findings after PSL was tapered off. However, seven months after the ICI administration, he developed rapid progressive glomerular nephritis and was admitted to our department again. The second kidney biopsy showed findings consistent with anti-glomerular basement membrane glomerulonephritis. Although the patient was treated with pulse methylprednisolone followed by oral PSL and plasma exchange, he became dependent on maintenance hemodialysis. To our knowledge, no case report has described two different types of biopsy-proven nephritis. In cases of suspected relapsing kidney irAEs, both a relapse of previous nephritis and the development of another type of nephritis should be considered.

查看原文本刊更多论文

ICI 治疗后两次急性肾损伤：病例报告。

一名患有肺鳞癌的74岁日本男性患者接受了首次免疫检查点抑制剂（ICIs）治疗：伊匹单抗（ipilimumab）和尼维单抗（nivolumab）。他出现了急性肾损伤（AKI），被送入我科。我们诊断为肾脏免疫相关不良反应（irAE），肾活检显示为急性肾小管间质性肾炎。我们开始口服泼尼松龙（PSL），他的 AKI 立即得到改善。PSL 停用后，患者的病情保持稳定。然而，在使用 ICI 7 个月后，他出现了快速进展性肾小球肾炎，并再次被送入我科。第二次肾活检结果显示与抗肾小球基底膜肾小球肾炎一致。虽然患者接受了脉冲甲基强的松龙治疗，随后又口服了 PSL 和血浆置换，但他还是需要依赖维持性血液透析。据我们所知，还没有病例报告描述过两种不同类型的活检证实的肾炎。在疑似复发性肾脏虹膜异位症的病例中，既要考虑先前肾炎的复发，也要考虑另一种肾炎的发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

CEN Case Reports UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： Clinical and Experimental Nephrology (CEN) Case Reports is a peer-reviewed online-only journal, officially published biannually by the Japanese Society of Nephrology (JSN). The journal publishes original case reports in nephrology and related areas. The purpose of CEN Case Reports is to provide clinicians and researchers with a forum in which to disseminate their personal experience to a wide readership and to review interesting cases encountered by colleagues all over the world, from whom contributions are welcomed.