Pembrolizumab-induced Acute Tubulointerstitial Nephritis Accompanying Fanconi Syndrome and Type 1 Renal Tubular Acidosis

Intern Med. 2024 Feb 15;63(4):533-539. doi: 10.2169/internalmedicine.1918-23. Epub 2023 Jun 28.

Abstract

Pembrolizumab, an immune checkpoint inhibitor, is used to treat a variety of refractory malignancies. However, these agents are sometimes associated with immune-related adverse events. A 71-year-old woman received pembrolizumab-integrated chemotherapy to treat her recurrent mandibular gingival cancer. Five months after stopping pembrolizumab, she developed acute tubulointerstitial nephritis associated with Fanconi syndrome and type 1 renal tubular acidosis, which resolved with steroid therapy. We experienced a case of pembrolizumab-induced Fanconi syndrome and type 1 renal acidosis. We recommend follow-up of the tubular function in addition to the renal function even after discontinuation of pembrolizumab.

Keywords: acute kidney injury; immune checkpoint inhibitor; immune-related adverse events.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Renal Tubular* / chemically induced
  • Acidosis, Renal Tubular* / complications
  • Aged
  • Antibodies, Monoclonal, Humanized*
  • Fanconi Syndrome* / chemically induced
  • Fanconi Syndrome* / complications
  • Fanconi Syndrome* / diagnosis
  • Female
  • Humans
  • Nephritis, Interstitial* / chemically induced
  • Nephritis, Interstitial* / diagnosis
  • Nephritis, Interstitial* / drug therapy

Substances

  • pembrolizumab
  • Antibodies, Monoclonal, Humanized

Supplementary concepts

  • Acute Tubulointerstitial Nephritis