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Pembrolizumab-induced focal segmental glomerulosclerosis: A case report.
Kim, Da Woon; Jeon, Hakeong; Kim, Sungmi; Lee, Wanhee; Kim, Hyo Jin; Rhee, Harin; Song, Sang Heon; Seong, Eun Young.
Afiliación
  • Kim DW; Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
  • Jeon H; Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
  • Kim S; Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
  • Lee W; Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
  • Kim HJ; Division of Nephrology, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
  • Rhee H; Division of Nephrology, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
  • Song SH; Division of Nephrology, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
  • Seong EY; Division of Nephrology, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
Medicine (Baltimore) ; 100(43): e27546, 2021 Oct 29.
Article en En | MEDLINE | ID: mdl-34713828
RATIONALE: Focal segmental glomerulosclerosis (FSGS) is the most common primary glomerular disorder that leads to end-stage kidney disease. Pembrolizumab, an immune checkpoint inhibitor, is an anti-programmed death 1 (PD-1) immunoglobulin G4 antibody approved for the treatment of advanced melanoma and can cause various renal immune-related adverse events (AEs), including acute kidney injury. Several cases of anti PD-1 therapy-induced glomerulonephritis have been reported so far, but FSGS has seldom been reported. PATIENT CONCERNS: 46-year old woman presented to our hospital with generalized edema. DIAGNOSES: Laboratory examination revealed features of nephrotic syndrome, and kidney biopsy confirmed FSGS. After other etiological factors of secondary FSGS were ruled out, she was diagnosed with FSGS caused by pembrolizumab. INTERVENTIONS: She did not resume treatment with pembrolizumab and was treated with irbesartan and furosemide according to the American Society of Clinical Oncology Practice guidelines. OUTCOMES: After 2 months, the features of nephrotic syndrome resolved. LESSONS: This case provides valuable insight into the etiology of FSGS that can occur as a renal immune-related AE of PD-1 inhibitor therapy. Therefore, patients should undergo evaluation for renal function and urinalysis at baseline and after treatment. If patients treated with PD-1 inhibitors present with renal injury and/or unexplained proteinuria >1 g/day, we would recommend a kidney biopsy to determine the underlying cause and establish an appropriate therapeutic plan.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glomeruloesclerosis Focal y Segmentaria / Anticuerpos Monoclonales Humanizados / Receptor de Muerte Celular Programada 1 / Antineoplásicos Inmunológicos Tipo de estudio: Guideline Límite: Female / Humans / Middle aged Idioma: En Revista: Medicine (Baltimore) Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glomeruloesclerosis Focal y Segmentaria / Anticuerpos Monoclonales Humanizados / Receptor de Muerte Celular Programada 1 / Antineoplásicos Inmunológicos Tipo de estudio: Guideline Límite: Female / Humans / Middle aged Idioma: En Revista: Medicine (Baltimore) Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos