Immune Checkpoint Inhibitor-Related Immunoglobulin A Nephropathy in a Patient with Advanced Head and Neck Cancer

Area of Science:

• Oncology
• Nephrology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) have transformed cancer therapy, particularly for head and neck cancers.
• Immune-related adverse events (irAEs) are common with ICIs, with kidney involvement, such as acute tubular injury and interstitial nephritis, being a significant concern.

Purpose of the Study:

• To report a rare case of IgA nephropathy as an immune-related adverse event (irAE) in a patient treated with nivolumab for advanced head and neck cancer.
• To highlight the diagnostic challenges and successful management of immune checkpoint inhibitor-related glomerulopathy.

Main Methods:

• A patient with advanced papillary squamous cell carcinoma of the head and neck received nivolumab after chemotherapy failure.
• The patient developed acute kidney injury, hematuria, and proteinuria shortly after nivolumab initiation.
• Diagnosis was confirmed by renal biopsy, revealing IgA nephropathy, and clinical presentation consistent with ICI-related kidney injury.

Main Results:

• The patient presented with acute kidney injury, hematuria, and proteinuria, indicative of glomerular damage.
• Renal biopsy confirmed IgA nephropathy, a rare manifestation of immune-related adverse events from immune checkpoint inhibitors.
• Treatment with steroids led to improved kidney function and complete remission, verified by urinalysis.

Conclusions:

• Immune checkpoint inhibitor-related IgA nephropathy is a rare but serious adverse event that can occur in patients treated with ICIs.
• Early diagnosis through renal biopsy and prompt treatment with corticosteroids can effectively manage ICI-induced glomerulopathy and improve patient outcomes.
• This case underscores the importance of vigilant monitoring for renal irAEs in patients receiving immunotherapy.