Renal Effects after Pembrolizumab Treatment for Non-small Cell Lung Carcinoma
Renal Effects after Pembrolizumab Treatment for Non-small Cell Lung Carcinoma
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DOI：
10.2169/internalmedicine.3928-19
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发表时间：
2020-01-01
影响因子：
1.2
通讯作者：
Nangaku, Masaomi
中科院分区：
文献类型：
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作者：
Oki, Rikako;Hirakawa, Yosuke;Nangaku, Masaomi
免疫检查点抑制剂（CPI），包括pembrolizumab，正在成为常见的肿瘤治疗。CPI与发生免疫相关不良事件（irAE）的显著风险相关，如肾炎和间质性肾炎。然而，肾小球肾炎的发生只有很少的报道。我们在此报告一例75岁女性非小细胞肺癌（NSCLC）患者，在接受派姆单抗治疗期间出现蛋白尿和镜下血尿。肾活检显示肾小管间质性肾炎和伊加肾病。考虑到治疗前尿分析未显示异常，该疾病可能是由帕博利珠单抗诱导的。在这份报告中，我们重点关注肾脏irAE的正确诊断和管理，这仍然是有争议的。
Immune checkpoint inhibitors (CPIs), including pembrolizumab, are becoming common oncological treatments. CPIs have been associated with a significant risk of developing immune-related adverse events (irAEs), such as nephritis and interstitial nephritis. However, the occurrence of glomerulonephritis has only rarely been reported. We herein present the case of a 75-year-old woman with non-small cell lung carcinoma (NSCLC) who developed proteinuria and microscopic hematuria during treatment with pembrolizumab. Renal biopsy revealed tubulointerstitial nephritis and IgA nephropathy. Considering that a urinalysis showed no abnormality before treatment, the condition might have been induced by pembrolizumab. hi this report, we focus on the correct diagnosis and management of renal irAEs, which remain controversial.