Severe acute interstitial nephritis after combination immune-checkpoint inhibitor therapy for metastatic melanoma.
Immune-checkpoint inhibitors are emerging as revolutionary drugs for certain malignancies. However, blocking the co-inhibitory signals may lead to immune-related adverse events, mainly in the spectrum of autoimmune diseases including colitis, endocrinopathies and nephritis. Here, we report a case of a 75-year-old man with metastatic malignant melanoma treated with a combination of nivolumab (anti-PD1-antibody) and ipilimumab (anti-CTLA-4 antibody) who developed systemic rash along with severe acute tubulointerstitial nephritis after two doses of combination therapy. Kidney biopsy and peripheral blood immune profile revealed highly proliferative and cytotoxic T cell features. Herein, we discuss the pathophysiology and management of immune checkpoint blockade-related adverse events.
Renal Division, Brigham & Women's Hospital , Harvard Medical School , Boston, MA , USA.
Naoka
N
Murakami
Renal Division, Brigham & Women's Hospital , Harvard Medical School , Boston, MA , USA.
Thiago J
TJ
Borges
Department of Pathology, Brigham and Women's Hospital , Harvard Medical School , Boston, MA , USA.
Michifumi
M
Yamashita
Renal Division, Brigham& Women's Hospital, Harvard Medical School, Boston, MA, USA; Transplantation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
Leonardo V
LV
Riella
acute kidney injury; immune-checkpoint blockade; interstitial nephritis