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ANCA-associated pauci-immune necrotizing glomerulonephritis during the treatment with pembrolizumab

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Abstract

Cancer immunotherapy is rapidly changing the treatment paradigm in oncology, and immune checkpoint inhibitors (ICPIs) have been used successfully in a variety of cancer types. Specific side effects termed immune-related adverse events (irAEs) have now been described in various organ systems, including the kidney. Renal complications have rarely been reported compared with other irAEs and mostly consist of acute interstitial nephritis. Only rare cases of ICPI-related glomerulonephritis have been described. Herein, we report the case of an adult patient treated with pembrolizumab (anti-PD-1) for squamous cell carcinoma (SCC), who developed infectious enterocolitis, and ANCA-related with diffuse necrotizing crescentic glomerulonephritis, both conditions potentially linked to treatment with pembrolizumab.

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Acknowledgments

Dr. Meral Uner was partially supported by the Hacettepe University Scientific Research Projects Coordination Unit (Project: TUI-2019-18392) during her fellowship.

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Authors and Affiliations

  1. Renal Pathology Department, Faculty of Medicine, Medical School of Johns Hopkins University, Baltimore, MD, USA

    Meral Uner, Bassam Alhasson & Serena M Bagnasco

  2. Pathology Department, Medical School of Hacettepe University, Ankara, Turkey

    Meral Uner

  3. Washington Nephrology Associate, Washington, DC, USA

    Jagdeep Obhrai

Authors
  1. Meral Uner
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  2. Bassam Alhasson
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  3. Jagdeep Obhrai
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  4. Serena M Bagnasco
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Contributions

Drs. Meral Uner and Serena M Bagnasco conceived and designed the study and wrote edited and reviewed the manuscript. Jagdeep Obhrai provided and gave the patient’s clinical information. Dr. Bassam Alhasson reviewed the literature and contributed to the introduction. All authors gave final approval for publication. Dr. Serena M Bagnasco takes full responsibility for the work as a whole, including the study design, access to data, and the decision to submit and publish the manuscript.

Corresponding author

Correspondence to Serena M Bagnasco.

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Uner, M., Alhasson, B., Obhrai, J. et al. ANCA-associated pauci-immune necrotizing glomerulonephritis during the treatment with pembrolizumab. Virchows Arch 478, 801–804 (2021). https://doi.org/10.1007/s00428-020-02882-w

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  • DOI: https://doi.org/10.1007/s00428-020-02882-w

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