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Adoptive Immunotherapy of iNKT Cells in Glucose-6-Phosphate Isomerase (G6PI)-Induced RA Mice
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Ipilimumab granulomatous interstitial nephritis.

Bijin Thajudeen1, Machaiah Madhrira, Erika Bracamonte

  • 1Departments of 1Nephrology, 2Pathology and 3Hematology/Oncology, University of Arizona Medical Center, Tucson, AZ.

American Journal of Therapeutics
|September 27, 2013
PubMed
Summary

This case report details a patient who developed granulomatous interstitial nephritis after receiving ipilimumab for metastatic melanoma. Steroid treatment led to recovery, highlighting a rare immune-related adverse event of this cancer therapy.

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Area of Science:

  • Nephrology
  • Oncology
  • Immunology

Background:

  • Drug-induced interstitial nephritis is a significant cause of acute and chronic kidney failure.
  • T-cell-mediated immune responses are key in the pathogenesis of interstitial nephritis.
  • Ipilimumab is a novel immunotherapy for metastatic melanoma.

Observation:

  • A 74-year-old male with metastatic melanoma presented with rash and declining renal function.
  • The patient had received three doses of ipilimumab within three months prior to renal failure onset.
  • Clinical presentation suggested medication-induced interstitial nephritis.

Findings:

  • Renal biopsy revealed granulomatous interstitial nephritis.
  • The findings, temporal relationship to ipilimumab, and literature review confirmed ipilimumab-induced renal failure.
  • This is the first reported case of ipilimumab-induced granulomatous interstitial nephritis.

Implications:

  • This case expands the spectrum of known immune-related adverse events associated with ipilimumab.
  • Early recognition and treatment with steroids can lead to renal function recovery.
  • Highlights the importance of considering ipilimumab as a potential cause of interstitial nephritis in melanoma patients.