Reintroduction of nivolumab in a patient with gastric cancer after improvement of nivolumab-induced acute interstitial nephritis: a case report
Reintroduction of nivolumab in a patient with gastric cancer after improvement of nivolumab-induced acute interstitial nephritis: a case report
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DOI：
10.1007/s13691-020-00418-2
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发表时间：
2020-05-22
影响因子：
0.7
通讯作者：
Mori, Masaki
中科院分区：
文献类型：
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作者：
Hu, Qingjiang;Hasuda, Hirofumi;Mori, Masaki
Nivolumab是一种抗程序性细胞死亡-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。在此，介绍了一例接受纳武利尤单抗治疗的66岁胃癌男性急性肾损伤病例。肾活检显示严重的急性间质性肾炎和轻度免疫球蛋白A肾病。急性肾损伤的原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。停止纳武利尤单抗和口服泼尼松龙给药迅速改善了患者的肾功能。然后重新开始纳武利尤单抗治疗，未出现肾功能恶化。据作者所知，这是第一例在胃癌患者中成功重新引入nivolumab的病例。此外，对nivolumab诱导的急性间质性肾炎的相关文献进行了综述。
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.