Internal medicine (Tokyo, Japan) · 2023
Renal Immune-related Adverse Event of Pembrolizumab Masked by Pemetrexed.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Nagase Koya, Murai Yukari, Yokoyama-Kokuryo Waka, Nagasaka Toru, Sato Yuki, Watanabe Tsuyoshi, Ito Yuki, Nagase Fumika, Fujita Yoshiro
Аннотация
A Japanese woman in her 60s developed a kidney injury 9 weeks after treatment with pemetrexed, carboplatin, and pembrolizumab for stage IV lung adenocarcinoma. A renal biopsy showed chronic tubulointerstitial damage with minimal focal interstitial inflammation, consistent with pemetrexed-induced nephropathy; thus, pemetrexed was withdrawn. However, the kidney injury continued to worsen. A repeated biopsy showed severe acute tubulointerstitial nephritis, suggestive of a pembrolizumab-induced immune-related adverse event (irAE). The worsening after pemetrexed discontinuation suggested that the irAE had already begun, as the first biopsy showed focal inflammation. This case suggests thatcombining immune checkpoints and chemotherapy requires considering concurrent drug-induced nephrotoxicity.