Okawa Sachi, Fujiwara Keiichi, Shimonishi Atsushi, Matsuura Hiroaki, Ozeki Taichi, Nishimura Jun, Kayatani Hiroe, Minami Daisuke, Shinno Yoko, Sato Ken, Ota Kosuke, Shibayama Takuo
Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Okayama, Japan.
Department of Pathology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
Case Rep Oncol. 2020 Feb 6;13(1):85-90. doi: 10.1159/000505235. eCollection 2020 Jan-Apr.
A 63-year-old man with pulmonary adenocarcinoma was treated with nivolumab. High fever developed within several hours after the first administration of nivolumab; subsequently, serum creatinine levels kept increasing daily. We diagnosed acute kidney injury (AKI) as an immune-related adverse event; the patient was initially treated with 50 mg prednisolone, and the dose was then tapered. Renal biopsy pathologically revealed tubulointerstitial inflammation with strong infiltration of only T cells that were CD3, CD4, and CD8. The infiltration of CD163 M2 macrophage was also observed. AKI within 1 week after the administration of nivolumab seems to be rare; therefore, the present case provides important findings useful in daily clinical practice.
一名63岁的肺腺癌男性患者接受了纳武单抗治疗。首次使用纳武单抗后数小时内出现高热；随后，血清肌酐水平每日持续升高。我们将急性肾损伤（AKI）诊断为免疫相关不良事件；患者最初接受50毫克泼尼松龙治疗，随后剂量逐渐减少。肾活检病理显示肾小管间质性炎症，仅有CD3、CD4和CD8的T细胞强烈浸润。还观察到CD163 M2巨噬细胞浸润。纳武单抗给药后1周内发生的AKI似乎很少见；因此，本病例提供了在日常临床实践中有用的重要发现。
