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Updated: Jan 7, 2026

Using 22C3 Anti-PD-L1 Antibody Concentrate on Biopsy and Cytology Samples from Non-small Cell Lung Cancer Patients
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ANCA-negative pauci-immune crescentic glomerulonephritis associated with nivolumab in lung cancer

Riri Furuyama1, Masahiro Eriguchi2, Manami Kamikawa1

  • 1Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.

CEN Case Reports
|January 4, 2026
PubMed

Immune checkpoint inhibitors (ICIs) have substantially improved the prognosis of many cancer patients but are also associated with various immune-related adverse events (irAEs). Kidney irAEs are relatively rare, with acute tubulointerstitial nephritis being the most common manifestation. However, some patients develop ICIs-associated glomerular diseases, including pauci-immune crescentic glomerulonephritis. In this report, we present the case of a 72-year-old man with lung squamous cell carcinoma treated with nivolumab, a monoclonal antibody targeting programmed cell death 1 (PD-1). The patient developed rapidly progressive glomerulonephritis a few weeks after initiating nivolumab therapy. Immunological tests yielded negative results, and a kidney biopsy revealed pauci-immune crescentic glomerulonephritis. Immunohistological examination confirmed programmed death ligand-1 (PD-L1) expression in the glomeruli. Despite intensive therapy, including corticosteroid pulse treatment, the patient's kidney function did not recover, necessitating maintenance hemodialysis. This is the first report demonstrating PD-L1 staining in injured glomeruli caused by anti-PD-1 therapy. Immunohistochemistry for PD-L1 may aid in diagnosing glomerulonephritis related to anti-PD-1 therapy.

Keywords:
Autoantibody-negative pauci-immune crescentic glomerulonephritisImmune checkpoint inhibitorsKidney immune-related adverse eventsNivolumabRapidly progressive glomerulonephritis

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