Rapidly progressive glomerulonephritis after immunotherapy for cancer.
Cytokines have been used in experimental and standard protocols for immune enhancement for cancer. The combination of interleukin-2 and interferon-alpha 2 beta has been used in experimental protocols for metastatic renal cell carcinoma. A man who developed rapidly progressive renal failure after receiving this combination therapy is reported. A renal biopsy revealed a pauci-immune crescentic glomerulonephritis. Antineutrophil cytoplasmic antibodies and antiglomerular basement membrane antibodies were absent. The spectrum of renal disease and potentially related extrarenal manifestations associated with interleukin-2 and inteferon-alpha are reviewed. A pathogenesis of altered cell-mediated immunity, consistent with abnormalities in extrarenal organs after immune enhancement, is proposed.
Parker
M G
MG
Division of Nephrology, New England Medical Center, Boston, MA, USA.
Atkins
M B
MB
Ucci
A A
AA
Levey
A S
AS
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary / Q000628:therapy*; D005921:Glomerulonephritis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D007376:Interleukin-2 / Q000009:adverse effects / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D011994:Recombinant Proteins
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D007376:Interleukin-2; D011994:Recombinant Proteins