PMID- 34713828
OWN - NLM
STAT- MEDLINE
DCOM- 20211105
LR  - 20230103
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 43
DP  - 2021 Oct 29
TI  - Pembrolizumab-induced focal segmental glomerulosclerosis: A case report.
PG  - e27546
LID - 10.1097/MD.0000000000027546 [doi]
LID - e27546
AB  - RATIONALE: Focal segmental glomerulosclerosis (FSGS) is the most common primary 
      glomerular disorder that leads to end-stage kidney disease. Pembrolizumab, an 
      immune checkpoint inhibitor, is an anti-programmed death 1 (PD-1) immunoglobulin 
      G4 antibody approved for the treatment of advanced melanoma and can cause various 
      renal immune-related adverse events (AEs), including acute kidney injury. Several 
      cases of anti PD-1 therapy-induced glomerulonephritis have been reported so far, 
      but FSGS has seldom been reported. PATIENT CONCERNS: 46-year old woman presented 
      to our hospital with generalized edema. DIAGNOSES: Laboratory examination 
      revealed features of nephrotic syndrome, and kidney biopsy confirmed FSGS. After 
      other etiological factors of secondary FSGS were ruled out, she was diagnosed 
      with FSGS caused by pembrolizumab. INTERVENTIONS: She did not resume treatment 
      with pembrolizumab and was treated with irbesartan and furosemide according to 
      the American Society of Clinical Oncology Practice guidelines. OUTCOMES: After 2 
      months, the features of nephrotic syndrome resolved. LESSONS: This case provides 
      valuable insight into the etiology of FSGS that can occur as a renal 
      immune-related AE of PD-1 inhibitor therapy. Therefore, patients should undergo 
      evaluation for renal function and urinalysis at baseline and after treatment. If 
      patients treated with PD-1 inhibitors present with renal injury and/or 
      unexplained proteinuria >1 g/day, we would recommend a kidney biopsy to determine 
      the underlying cause and establish an appropriate therapeutic plan.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Kim, Da Woon
AU  - Kim DW
AD  - Department of Internal Medicine, Pusan National University Hospital, Busan, 
      Korea.
FAU - Jeon, Hakeong
AU  - Jeon H
AD  - Department of Internal Medicine, Pusan National University Hospital, Busan, 
      Korea.
FAU - Kim, Sungmi
AU  - Kim S
AD  - Department of Internal Medicine, Pusan National University Hospital, Busan, 
      Korea.
FAU - Lee, Wanhee
AU  - Lee W
AD  - Department of Internal Medicine, Pusan National University Hospital, Busan, 
      Korea.
FAU - Kim, Hyo Jin
AU  - Kim HJ
AD  - Division of Nephrology, Department of Internal Medicine, Biomedical Research 
      Institute, Pusan National University Hospital, Busan, South Korea.
FAU - Rhee, Harin
AU  - Rhee H
AD  - Division of Nephrology, Department of Internal Medicine, Biomedical Research 
      Institute, Pusan National University Hospital, Busan, South Korea.
FAU - Song, Sang Heon
AU  - Song SH
AD  - Division of Nephrology, Department of Internal Medicine, Biomedical Research 
      Institute, Pusan National University Hospital, Busan, South Korea.
FAU - Seong, Eun Young
AU  - Seong EY
AUID- ORCID: 0000-0002-6006-0051
AD  - Division of Nephrology, Department of Internal Medicine, Biomedical Research 
      Institute, Pusan National University Hospital, Busan, South Korea.
LA  - eng
GR  - Not available/pusan national university hospital/
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 0 (Programmed Cell Death 1 Receptor)
RN  - DPT0O3T46P (pembrolizumab)
SB  - IM
MH  - Antibodies, Monoclonal, Humanized/*adverse effects
MH  - Antineoplastic Agents, Immunological/*adverse effects
MH  - Female
MH  - Glomerulosclerosis, Focal Segmental/*chemically induced
MH  - Humans
MH  - Middle Aged
MH  - Programmed Cell Death 1 Receptor/*antagonists & inhibitors
PMC - PMC8556051
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/10/30 06:00
MHDA- 2021/11/06 06:00
PMCR- 2021/10/29
CRDT- 2021/10/29 08:55
PHST- 2021/07/19 00:00 [received]
PHST- 2021/10/01 00:00 [accepted]
PHST- 2021/10/29 08:55 [entrez]
PHST- 2021/10/30 06:00 [pubmed]
PHST- 2021/11/06 06:00 [medline]
PHST- 2021/10/29 00:00 [pmc-release]
AID - 00005792-202110290-00008 [pii]
AID - MD-D-21-05049 [pii]
AID - 10.1097/MD.0000000000027546 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 Oct 29;100(43):e27546. doi: 
      10.1097/MD.0000000000027546.