Department of Respiratory Medicine, National Hospital Organization Hamada Medical Center, Japan.
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan.
Intern Med. 2022 Jul 1;61(13):2013-2017. doi: 10.2169/internalmedicine.7115-21. Epub 2021 Nov 27.
A 70-year-old man received pembrolizumab as a second-line treatment for squamous cell lung cancer of the lower right lobe. After three courses, proteinuria and hematuria were observed, which worsened after seven courses. He was diagnosed with a combination of IgA nephropathy and active interstitial nephritis. Steroid pulse therapy was started, and the dose of prednisolone was gradually reduced from 60 mg/day. Renal dysfunction as an immune-related adverse event of pembrolizumab monotherapy for non-small cell lung cancer has been reported previously. Therefore, establishing a system for the early detection and treatment that distinguishes immune-related glomerular diseases is essential.
一位 70 岁男性因右下肺鳞状细胞癌接受派姆单抗二线治疗。治疗 3 个疗程后出现蛋白尿和血尿,7 个疗程后加重。他被诊断为 IgA 肾病和活动性间质性肾炎。开始进行激素脉冲治疗,泼尼松剂量逐渐从 60mg/天减少。先前已有报道称,派姆单抗单药治疗非小细胞肺癌的免疫相关不良反应会导致肾功能障碍。因此,建立一个早期检测和治疗的系统,以区分免疫相关肾小球疾病至关重要。