Academic Journal
MO136: Histological Findings in Checkpoint Inhibitor-Induced Nephropathy
| العنوان: | MO136: Histological Findings in Checkpoint Inhibitor-Induced Nephropathy |
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| المؤلفون: | Gerakis, Alexander, Kaitantzoglou, Christine, Giatras, Ioannis, Stauridi, Flora, Labropoulos, Stefanos, Athanasiadis, Ilias, Kosmidis, Paraskeuas, Gakiopoulou, Harikleia |
| المصدر: | Nephrology Dialysis Transplantation ; volume 37, issue Supplement_3 ; ISSN 0931-0509 1460-2385 |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Transplantation, Nephrology |
| الوصف: | BACKGROUND AND AIMS Immune checkpoint inhibitors (CPIs)—a landmark in cancer therapy—has been occasionally associated with immune-related nephropathy [1]. Acute interstitial nephritis is considered to be the most common underlying histological entity, according to recent literature [2]. METHOD We report on six patients, 58–73 years old, three women and three men who presented with acute kidney disease, while on immunotherapy with CPIs. Five of them carried the diagnosis of non-small cell lung carcinoma (NSCLC) and one the diagnosis of renal cell carcinoma. All received proton pump inhibitors and experienced one or more of immune-related adverse events (dermatitis, arthritis, colitis, hepatitis and pneumonitis), prior to nephropathy. All underwent kidney biopsy. RESULTS Two female patients, both with NSCLC, developed heavy nephrotic syndrome (serum albumin: 1.7–1.8 mg/dL and 24-h urine protein: 12–16 g), after 23–28 months on pembrolizumab monotherapy, which was withdrawn. In the first patient, kidney biopsy demonstrated histology consistent with a lupus like membranous nephropathy (Figure 1). She received corticosteroids with partial recovery. Rechallenge with pembrolizumab was attempted and well tolerated. Renal biopsy of the second patient demonstrated a secondary AA (+) amyloidosis (Figure 2). She showed increased levels of SAA (114 mg/L) and IL-1b (22.9 pg/mL). She received colchicine and moderate dose of corticosteroids with partial remission. Two other patients, with NSCLC and clear cell renal carcinoma respectively, demonstrated renal biopsy findings consistent with acute interstitial nephritis (serum creatinine 1.5–1.6 mg/dL). The first one was on pembrolizumab along with cisplatin and pemetrexed, while the second one was on pembrolizumab along with axitinib. Both received prednisolone (10–20 mg for 3 months approximately). Pembrolizumab was restarted thereafter. Their renal function remained stable. Finally, two patients with NSCLC, both men, disclosed acute renal failure (serum creatinine: ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1093/ndt/gfac066.038 |
| الاتاحة: | http://dx.doi.org/10.1093/ndt/gfac066.038 https://academic.oup.com/ndt/article-pdf/37/Supplement_3/gfac066.038/43534441/gfac066_038.pdf |
| Rights: | https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| رقم الانضمام: | edsbas.82EFF8A4 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/ndt/gfac066.038 |
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