Department of Medicine, University of California, Los Angeles, CA 90095, USA.
Department of Pathology, University of California, Los Angeles, CA 90095, USA.
Immunotherapy. 2021 Mar;13(4):283-288. doi: 10.2217/imt-2020-0223. Epub 2021 Jan 5.
Renal toxicity from immune checkpoint inhibitors (ICIs) is an increasingly recognized cause of acute kidney injury among patients with cancer. ICI-associated acute kidney injuries typically present as acute interstitial nephritis and the timing of onset is highly variable. Herein, we present a case of a patient with relapsed metastatic melanoma previously treated with pembrolizumab who developed grade 3 immune-related renal toxicity after reintroduction of the same ICI, secondary to acute interstitial nephritis with accompanying high PR3-antineutrophil cytoplasmic antibody titer. The patient improved after steroid treatment and discontinuation of pembrolizumab. This case highlights the importance of not excluding ICI-related nephrotoxicity as a possible cause of renal failure, including in those who previously tolerated ICI treatment, since it is a treatable entity.
免疫检查点抑制剂（ICIs）引起的肾毒性是癌症患者急性肾损伤的一个日益被认识的原因。ICI 相关性急性肾损伤通常表现为急性间质性肾炎，其发病时间高度可变。在此，我们介绍了一例先前接受过 pembrolizumab 治疗的复发性转移性黑色素瘤患者的病例，该患者在重新引入相同的 ICI 后发生了 3 级免疫相关的肾毒性，继发于伴有高 PR3-抗中性粒细胞胞质抗体滴度的急性间质性肾炎。患者在接受类固醇治疗和停用 pembrolizumab 后有所改善。本病例强调了不应排除 ICI 相关性肾毒性作为肾衰竭的可能原因，包括那些先前耐受 ICI 治疗的患者，因为它是一种可治疗的疾病。
