Rapidly Progressive Pauci-Immune Glomerulonephritis with Aberrant Fibrinoid Necrosis Associated with Atezolizumab, an Immune Check Point Inhibitor: A Case Report and Review of Literature

被引：4

作者：

Nikolopoulos, Petros ^{[1
]}

Liapis, George ^{[2
]}

Giannakopoulos, Panagiotis ^{[1
]}

Kotsantis, Ioannis ^{[3
]}

Drouzas, Konstantinos ^{[1
]}

Lionaki, Sophia ^{[1
]}

机构：

[1] Natl & Kapodistrian Univ Athens, Attikon Hosp, Med Sch, Dept Propaedeut Internal Med 2,Sect Nephrol, Athens 12462, Greece

[2] Natl & Kapodistrian Univ Athens, Laiko Hosp, Dept Pathol 1, Athens 11527, Greece

[3] Natl & Kapodistrian Univ Athens, Attikon Hosp, Med Sch, Dept Propaedeut Internal Med 2,Sect Med Oncol, Athens 12462, Greece

来源：

ANTIBODIES | 2023年 / 12卷 / 01期

关键词：

acute kidney injury (AKI); vasculitis; immunotherapy; checkpoint inhibitors; immune related adverse effect; onconephrology; NIVOLUMAB; ANTIBODY;

D O I：

10.3390/antib12010010

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Stimulation of the antitumor activity of the immune system using immune checkpoint inhibitors (ICIs) has proven efficacy in the treatment of multiple types of cancer, inducing the speedily expanding approval of therapeutic indications for ICIs. The literature regarding the immune-related toxicities and nephrotoxicity of ICIs is limited. Herein, we present a patient with lung cancer treated with atezolizumab, an IgG1 monoclonal antibody aimed at the programmed death ligand 1 (PD-L1), who presented with vasculitic skin rash and rapidly deteriorating renal function, new onset of significant glomerular hematuria and proteinuria. The renal biopsy revealed acute necrotizing pauci-immune vasculitis, with fibrinoid necrosis. The patient received a course of high-dose glucocorticoids with recovery of renal function and skin lesions. Further immunosuppressive therapy was withheld, due to active malignancy in the lung, while oncology consultation recommended the continuation of treatment with atezolizumab, as the patient had shown substantial response.

引用

页数：7

共 28 条

[1] Risk of pneumonitis in cancer patients treated with immune checkpoint inhibitors: a meta-analysis [J].

Abdel-Rahman, Omar ;

Fouad, Mona .

THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE, 2016, 10 (03) :183-193

[2] Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer [J].

Antonia, S. J. ;

Villegas, A. ;

Daniel, D. ;

Vicente, D. ;

Murakami, S. ;

Hui, R. ;

Yokoi, T. ;

Chiappori, A. ;

Lee, K. H. ;

de Wit, M. ;

Cho, B. C. ;

Bourhaba, M. ;

Quantin, X. ;

Tokito, T. ;

Mekhail, T. ;

Planchard, D. ;

Kim, Y. -C. ;

Karapetis, C. S. ;

Hiret, S. ;

Ostoros, G. ;

Kubota, K. ;

Gray, J. E. ;

Paz-Ares, L. ;

de Castro Carpeno, J. ;

Wadsworth, C. ;

Melillo, G. ;

Jiang, H. ;

Huang, Y. ;

Dennis, P. A. ;

Ozguroglu, M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2017, 377 (20) :1919-1929

[3] Immune-related adverse events for anti-PD-1 and anti-PD-L1 drugs: systematic review and meta-analysis [J].

Baxi, Shrujal ;

Yang, Annie ;

Gennarelli, Renee L. ;

Khan, Niloufer ;

Wang, Ziwei ;

Boyce, Lindsay ;

Korenstein, Deborah .

BMJ-BRITISH MEDICAL JOURNAL, 2018, 360

[4] Pembrolizumab for Patients With Refractory or Relapsed Thymic Epithelial Tumor: An Open-Label Phase II Trial [J].

Cho, Jinhyun ;

Kim, Hae Su ;

Ku, Bo Mi ;

Choi, Yoon-La ;

Cristescu, Razvan ;

Han, Joungho ;

Sun, Jong-Mu ;

Lee, Se-Hoon ;

Ahn, Jin Seok ;

Park, Keunchil ;

Ahn, Myung-Ju .

JOURNAL OF CLINICAL ONCOLOGY, 2019, 37 (24) :2162-+

[5] Clinicopathological features of acute kidney injury associated with immune checkpoint inhibitors [J].

Cortazar, Frank B. ;

Marrone, Kristen A. ;

Troxell, Megan L. ;

Ralto, Kenneth M. ;

Hoenig, Melanie P. ;

Brahmer, Julie R. ;

Le, Dung T. ;

Lipson, Evan J. ;

Glezerman, Ilya G. ;

Wolchok, Jedd ;

Cornell, Lynn D. ;

Feldman, Paul ;

Stokes, Michael B. ;

Zapata, Sarah A. ;

Hodi, F. Stephen ;

Ott, Patrick A. ;

Yamashita, Michifumi ;

Leaf, David E. .

KIDNEY INTERNATIONAL, 2016, 90 (03) :638-647

[6] Preclinical pharmacokinetics, pharmacodynamics, tissue distribution, and tumor penetration of anti-PD-L1 monoclonal antibody, an immune checkpoint inhibitor [J].

Deng, Rong ;

Bumbaca, Daniela ;

Pastuskovas, Cinthia V. ;

Boswell, C. Andrew ;

West, David ;

Cowan, Kyra J. ;

Chiu, Henry ;

McBride, Jacqueline ;

Johnson, Clarissa ;

Xin, Yan ;

Koeppen, Hartmut ;

Leabman, Maya ;

Iyer, Suhasini .

MABS, 2016, 8 (03) :593-603

[7]

Dine J, 2017, ASIA-PAC J ONCOL NUR, V4, P127, DOI 10.4103/apjon.apjon_4_17

[8] Renal Vasculitis and Pauci-immune Glomerulonephritis Associated With Immune Checkpoint innioitors [J].

Gallan, Alexander J. ;

Alexander, Ellen ;

Reid, Pankti ;

Kutuby, Fouad ;

Chang, Anthony ;

Henriksen, Kammi J. .

AMERICAN JOURNAL OF KIDNEY DISEASES, 2019, 74 (06) :853-856

[9] Acute kidney injury in patients treated with immune checkpoint inhibitors [J].

Gupta, Shruti ;

Short, Samuel A. P. ;

Sise, Meghan E. ;

Prosek, Jason M. ;

Madhavan, Sethu M. ;

Soler, Maria Jose ;

Ostermann, Marlies ;

Herrmann, Sandra M. ;

Abudayyeh, Ala ;

Anand, Shuchi ;

Glezerman, Ilya ;

Motwani, Shveta S. ;

Murakami, Naoka ;

Wanchoo, Rimda ;

Ortiz-Melo, David, I ;

Rashidi, Arash ;

Sprangers, Ben ;

Aggarwal, Vikram ;

Malik, A. Bilal ;

Loew, Sebastian ;

Carlos, Christopher A. ;

Chang, Wei-Ting ;

Beckerman, Pazit ;

Mithani, Zain ;

Shah, Chintan, V ;

Renaghan, Amanda D. ;

De Seigneux, Sophie ;

Campedel, Luca ;

Kitchlu, Abhijat ;

Shin, Daniel Sanghoon ;

Rangarajan, Sunil ;

Deshpande, Priya ;

Coppock, Gaia ;

Eijgelsheim, Mark ;

Seethapathy, Harish ;

Lee, Meghan D. ;

Strohbehn, Ian A. ;

Owen, Dwight H. ;

Husain, Marium ;

Garcia-Carro, Clara ;

Bermejo, Sheila ;

Lumlertgul, Nuttha ;

Seylanova, Nina ;

Flanders, Lucy ;

Isik, Busra ;

Mamlouk, Omar ;

Lin, Jamie S. ;

Garcia, Pablo ;

Kaghazchi, Aydin ;

Khanin, Yuriy .

JOURNAL FOR IMMUNOTHERAPY OF CANCER, 2021, 9 (10)

[10] Immune Checkpoint Inhibitor Nephrotoxicity: Update 2020 [J].

Gupta, Shruti ;

Cortazar, Frank B. ;

Riella, Leonardo V. ;

Leaf, David E. .

KIDNEY360, 2020, 1 (02) :130-140

← 1 2 3 →