Tubulointerstitial nephritis as adverse effect of programmed cell death 1 inhibitor, nivolumab, showed distinct histological findings
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Immune-checkpoint inhibitor nivolumab (anti-PD-1 antibody) blocks T cell inhibition and stimulate immunologic response toward cancer cells. It was also revealed that PD-1/PD-L1 interaction crucially controls the effector differentiation of auto-reactive T cells to maintain self-tolerance. Therefore, potential autoimmunological side-effect can occur in any organ. Here, we report a case of 67-year-old Japanese male with lung adenocarcinoma treated with nivolumab who developed acute tubulointerstitial nephritis after the third infusion of nivolumab. Kidney biopsy showed distinct histological findings: Proliferation of CD38 positive and IgG positive plasma cells, and affluent infiltration of FoxP3+ regulatory T cells. Herein, we do pathological discussion concerning acute tubulointerstitial nephritis occurred in this case based on these histological findings.
KeywordsImmune-checkpoint inhibitor Anti-programmed cell death-1 Nivolumab Tubulointerstitial nephritis FoxP3
We thank Drs. Mamoru Tanaka and Yusuke Kashiwado (Kyushu University) for their generous help on immunofluorescent study.
Compliance with ethical standards
Ethics approval and consent to participate
This study was exempted from institutional review board approval because it was a case report.
Conflict of interest
All the authors have declared no competing interests.
Informed consent was obtained from the patient in this report.
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