Hu Qingjiang, Hasuda Hirofumi, Ueki Kenji, Tsuchimoto Akihiro, Zaitsu Yoko, Tsuda Yasuo, Hisamatsu Yuichi, Nakashima Yuichiro, Ando Koji, Kimura Yasue, Oki Eiji, Mori Masaki
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582 Japan.
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Int Cancer Conf J. 2020 May 22;9(3):127-132. doi: 10.1007/s13691-020-00418-2. eCollection 2020 Jul.
Nivolumab, an anti-programmed cell death-1 (PD-1) antibody, has attracted increasing attention as a new treatment modality for gastric cancer. Herein, a case of acute kidney injury in a 66-year-old man with gastric cancer treated with nivolumab is presented. Kidney biopsy revealed severe acute interstitial nephritis and mild immunoglobulin A nephropathy. The cause of acute kidney injury was considered as acute interstitial nephritis because the main site of the lesion was the tubulointerstitium. Cessation of nivolumab and oral prednisolone administration rapidly improved the patient's renal function. Nivolumab was then restarted without worsening of renal function. To the best of the authors knowledge, this is the first case in which reintroduction of nivolumab was successfully performed in a patient with gastric cancer. Further, the relevant literature was reviewed on nivolumab-induced acute interstitial nephritis.
纳武单抗是一种抗程序性细胞死亡蛋白1（PD-1）抗体，作为胃癌的一种新治疗方式已引起越来越多的关注。本文报告了一例66岁接受纳武单抗治疗的胃癌男性患者发生急性肾损伤的病例。肾活检显示严重急性间质性肾炎和轻度免疫球蛋白A肾病。急性肾损伤的病因被认为是急性间质性肾炎，因为病变的主要部位是肾小管间质。停用纳武单抗并给予口服泼尼松龙迅速改善了患者的肾功能。随后重新使用纳武单抗，肾功能未恶化。据作者所知，这是首例在胃癌患者中成功重新使用纳武单抗的病例。此外，还对纳武单抗诱导的急性间质性肾炎的相关文献进行了综述。
