Renal Sarcoidosis-like Reaction Induced by PD-1 Inhibitor Treatment in Non-Small Cell Lung Cancer: A Case Report and Literature Review

Author:

Park Sang-Don1ORCID,Kim Mee-Seon2ORCID,Han Man-Hoon2ORCID,Kim Yong-Jin2,Jung Hee-Yeon1,Choi Ji-Young1ORCID,Cho Jang-Hee1ORCID,Park Sun-Hee1ORCID,Kim Chan-Duck1ORCID,Kim Yong-Lim1ORCID,Lim Jeong-Hoon1ORCID

Affiliation:

1. Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea

2. Department of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Republic of Korea

Abstract

Monoclonal antibodies directed against immune checkpoint proteins have been widely used to treat various cancers and have resulted in favorable clinical outcomes. Despite these beneficial properties, immune checkpoint inhibitors (ICIs) can induce side effects called immune-related adverse events, including sarcoidosis-like reactions (SLR) across multiple organs. Here, we report a case of renal SLR after ICI treatment, and we review the related literature. A 66-year-old Korean patient with non-small cell lung cancer was referred to the nephrology clinic for renal failure after the 14th pembrolizumab treatment dose. A renal biopsy revealed multiple epithelioid cell granulomas, with several lymphoid aggregates in the renal interstitium and a moderate degree of inflammatory cell infiltration in the tubulointerstitium. A moderate dose of steroid therapy was initiated, and the serum creatinine level partially recovered after four weeks of treatment. Judicious monitoring of renal SLR is, therefore, required during ICI therapy, and a timely diagnosis by renal biopsy and appropriate treatment are important.

Funder

Korea Health Industry Development Institute

Ministry of Health &Welfare, Republic of Korea

National Research Foundation of Korea

Publisher

MDPI AG

Subject

General Medicine

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