1例晚期头颈癌患者的免疫检查点抑制剂相关免疫球蛋白A肾病。

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Sae Aratani, Takeshi Matsunobu, Masashi Nakaishi, Akira Shimizu, Tetsuya Kashiwagi, Yukinao Sakai, Kimihiro Okubo, Masato Iwabu
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引用次数: 0

摘要

免疫检查点抑制剂(ICIs)已经彻底改变了许多癌症的治疗,包括头颈部癌症。尽管ICIs具有良好的治疗效果,但免疫相关不良事件(irAEs)仍是一个主要问题。急性肾小管损伤和间质性肾炎是最常见的累及肾脏的肾炎。本病例被诊断为头颈部晚期乳头状鳞状细胞癌。在包括化疗在内的初始治疗失败后,引入了nivolumab(程序性死亡-1抑制剂)。在最初给予纳武单抗后不久,患者出现急性肾损伤,伴有血尿和蛋白尿。肾活检和他的临床过程显示诊断为ici相关的IgA肾病。尽管肾小球受累在irAEs中是罕见的,并且具有挑战性的治疗,本例患者成功地使用类固醇治疗,改善了肾功能并导致完全缓解,尿分析证实了这一点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immune checkpoint inhibitor-related immunoglobulin A nephropathy in a patient with advanced head and neck cancer.

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of many cancers, including cancers of the head and neck. Despite the promising therapeutic efficacy of ICIs, immune-related adverse events (irAEs) are a major concern. Acute tubular injury and interstitial nephritis are the most common irAEs involving the kidneys. The present patient was diagnosed as having advanced papillary squamous cell carcinoma of the head and neck. After failure of the initial treatments, including chemotherapy, nivolumab (programmed death-1 inhibitor) was introduced. Shortly after initial administration of nivolumab, the patient developed acute kidney injury with hematuria and proteinuria. A renal biopsy and his clinical course indicated a diagnosis of ICI-related IgA nephropathy. Although glomerular involvement in irAEs is rare and challenging to treatment, the present patient was successfully treated with steroids, which improved kidney function and led to complete remission, as confirmed by urinalysis.

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来源期刊
Journal of Nippon Medical School
Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-
CiteScore
1.80
自引率
10.00%
发文量
118
期刊介绍: The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.
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