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Tubulointerstitial nephritis as adverse effect of programmed cell death 1 inhibitor, nivolumab, showed distinct histological findings

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Abstract

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.

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Acknowledgements

We thank Drs. Mamoru Tanaka and Yusuke Kashiwado (Kyushu University) for their generous help on immunofluorescent study.

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Authors and Affiliations

  1. Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan

    Ai Uchida, Maho Watanabe, Masaru Sasaki, Kana Shigemoto & Hitoshi Nakashima

  2. Division of Pathology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan

    Aya Nawata & Satoshi Hisano

  3. Division of Medical Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan

    Yosuke Ikari

Authors
  1. Ai Uchida
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  2. Maho Watanabe
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  3. Aya Nawata
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  4. Yosuke Ikari
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  5. Masaru Sasaki
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  6. Kana Shigemoto
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  7. Satoshi Hisano
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  8. Hitoshi Nakashima
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Corresponding author

Correspondence to Ai Uchida.

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This study was exempted from institutional review board approval because it was a case report.

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All the authors have declared no competing interests.

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Informed consent was obtained from the patient in this report.

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Uchida, A., Watanabe, M., Nawata, A. et al. Tubulointerstitial nephritis as adverse effect of programmed cell death 1 inhibitor, nivolumab, showed distinct histological findings. CEN Case Rep 6, 169–174 (2017). https://doi.org/10.1007/s13730-017-0269-y

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  • DOI: https://doi.org/10.1007/s13730-017-0269-y

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