Vedolizumab is a gut-selective humanized monoclonal antibody that binds selectively to the α4 β7 integrin and acts as a lymphocyte-homing antagonist. It is indicated in ulcerative colitis and Crohn disease. We report a case of acute interstitial nephritis following vedolizumab infusion in a 55-year-old white woman treated for severe Crohn disease resistant to several therapies. Other kidney disease causes were ruled out. Glucocorticoids were administrated, leading to full renal recovery. In the absence of other therapeutic options, vedolizumab was re-administered along with transient corticosteroids; this treatment was well tolerated. Fewer than 10 cases of immunoallergic acute interstitial nephritis following treatment with monoclonal antibody have previously been reported in the literature. The pathophysiology of delayed-type hypersensitivity secondary to monoclonal antibody therapeutics is discussed in this case report.
Keywords: Crohn’s disease; Inflammatory bowel disease (IBD); acute interstitial nephritis (AIN); acute kidney injury (AKI); acute renal failure (ARF); case report; glucocorticoids; kidney biopsy; monoclonal antibody; ulcerative colitis; vedolizumab.
Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.