title: Interstitial nephritis in melanoma patients secondary to PD-1 checkpoint inhibitor.
abstract: Immune checkpoint inhibitors have become the first line therapy in melanoma treatment and their use is extending to other malignancies. However, we are still learning about immune side effects produced by these drugs and their severity especially in patients with history of inflammatory diseases.
  
  
  
  We present two cases of metastatic melanoma treated with nivolumab and pembrolizumab (anti PD-1). Both patients developed acute interstitial nephritis during immune checkpoint therapy. We emphasize the causal association between immune checkpoint inhibitors and the nephritis. The timing of drug administration and appearance of nephritis is suggestive of a causal relation between the checkpoint inhibitor therapy and this adverse event.
  
  
  
  Although uncommon, some side effects from checkpoint inhibitors can be severe and may need to be addressed with immunosuppression. Given the increasing frequency of immunotherapy use, awareness should be raised in regards to immune side effects and their appropriate management.
authors.affiliation: Mount Sinai Medical Center, Miami Beach, FL USA ; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Escandon
authors.affiliation: Mount Sinai Medical Center, Miami Beach, FL USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Peacock
authors.affiliation: Mount Sinai Medical Center, Miami Beach, FL USA.
authors.forename: Asaad
authors.initials: A
authors.lastname: Trabolsi
authors.affiliation: Department of Pathology, University of Miami, Miami, FL USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Thomas
authors.affiliation: Mount Sinai Medical Center, Miami Beach, FL USA.
authors.forename: Ayman
authors.initials: A
authors.lastname: Layka
authors.affiliation: Mount Sinai Medical Center, Miami Beach, FL USA ; Melanoma Program, Division of Hematology/Oncology, Mount Sinai Comprehensive Cancer Center, 4306 Alton Road, Miami Beach, FL 33140 USA.
authors.forename: Jose
authors.initials: J
authors.lastname: Lutzky
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D007167:Immunotherapy; D007249:Inflammation / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D000074324:Ipilimumab / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009395:Nephritis, Interstitial / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D000077594:Nivolumab; D061026:Programmed Cell Death 1 Receptor / Q000037:antagonists & inhibitors / Q000276:immunology*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000074324:Ipilimumab; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor; D000077594:Nivolumab; C582435:pembrolizumab
keywords: Immune checkpoint inhibitor; Interstitial nephritis; Nivolumab; PD-1 ligand (PD-L1); Pembrolizumab; Programed death 1 receptor (PD-1)