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纳武单抗诱导的急性肾小管损伤:一例报告。

Nivolumab-induced acute tubular injury: A case report.

作者信息

Yang Hui-Hsin, Chang Chia-Wen, Chen Tai-Di

机构信息

Department of Pharmacy Chang Gung Memorial Hospital, Taoyuan Taoyuan City Taiwan.

Department of Nephrology Chang Gung Memorial Hospital, Linkou Taiwan.

出版信息

Clin Case Rep. 2023 Mar 7;11(3):e6991. doi: 10.1002/ccr3.6991. eCollection 2023 Mar.

DOI:10.1002/ccr3.6991
PMID:36911644
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9992483/
Abstract

Nivolumab belongs to immune checkpoint inhibitors (ICIs). ICIs-induced kidney injury is rare and acute interstitial nephritis (AIN) is the majority. A 58-year-old woman had gastric cancer treated with nivolumab. Her serum creatinine (Cr) increased to 5.94 mg/dL post 2 cycles of nivolumab and co-administered with acemetacin. A kidney biopsy showed acute tubular injury (ATI). Nivolumab rechallenge was done and Cr worsened again. The lymphocyte transformation test (LTT) indicated a strong positive for nivolumab. Although rare, ATI due to ICIs could not be ruled out, and LTT is a tool to identify the culprit.

摘要

纳武利尤单抗属于免疫检查点抑制剂(ICIs)。ICIs 引起的肾损伤较为罕见,其中急性间质性肾炎(AIN)占大多数。一名 58 岁女性患有胃癌,接受纳武利尤单抗治疗。在接受 2 个周期的纳武利尤单抗治疗并同时使用阿西美辛后,她的血清肌酐(Cr)升至 5.94 mg/dL。肾脏活检显示为急性肾小管损伤(ATI)。再次使用纳武利尤单抗后 Cr 再次恶化。淋巴细胞转化试验(LTT)显示对纳武利尤单抗呈强阳性。尽管罕见,但不能排除 ICIs 导致的 ATI,而 LTT 是识别病因的一种工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82d5/9992483/5e5cee46b199/CCR3-11-e6991-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82d5/9992483/0a6d0cf7d1f8/CCR3-11-e6991-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82d5/9992483/5e5cee46b199/CCR3-11-e6991-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82d5/9992483/0a6d0cf7d1f8/CCR3-11-e6991-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82d5/9992483/5e5cee46b199/CCR3-11-e6991-g003.jpg

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本文引用的文献

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Multiple autoimmune side effects of immune checkpoint inhibitors in a patient with metastatic melanoma receiving pembrolizumab.患者接受派姆单抗治疗转移性黑色素瘤后出现多种免疫检查点抑制剂相关的自身免疫副作用。
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