Interstitial nephritis treated with nivolumab in lung cancer patients with membranous nephropathy
Machiko Matsumoto-Sasakia Hidenori Mizugakia Jun Sakakibara-Konishia Keiichi Kondob Yuichiro Fukasawac Satoshi Konnoa
aFirst Department of Medicine, Hokkaido University Hospital
bSecond Department of Medicine, Hokkaido University Hospital
cDepartment of Pathology, Sapporo City General Hospital
A 65-year-old woman was referred to our department of internal medicine for the examination of nephrotic syndrome. She had a history of proteinuria half a year prior. A tumor shadow was pointed out in the lower lobe of the left-sided lung and she was sent to our department. The patient was diagnosed with primary lung squamous cell carcinoma (cStage IV). In addition, she was diagnosed as having membranous nephropathy, which was the cause of her nephrotic syndrome. There was exacerbation in the primary site after the first treatment, and nivolumab was started as the second treatment. A Grade 2 creatinine level elevation was observed on the fifth day of the first course, and a renal biopsy was performed. Histopathological diagnoses were membranous nephropathy and tubulointerstitial nephritis.Nivolumab was administered every 1.5 to 4 months to maintain a partial response.
Lung cancer Nivolumab Tubulointerstitial nephritis (TIN) Membranous nephropathy Immune related adverse event (irAE)
Received 2 Jun 2019 / Accepted 23 Oct 2019
AJRS, 9(1): 71-75, 2020