Clinical Report: IgG4-Related Disease Induced by Immune Checkpoint Inhibitors

Overview

This case study presents a 65-year-old man with metastatic clear cell renal carcinoma who developed IgG4-related disease (IgG4-RD) following treatment with nivolumab and ipilimumab. The condition was managed with rituximab.

Background

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but are associated with various immune-related adverse events (irAEs). IgG4-RD is a rare irAE that can mimic malignant progression, complicating the management of cancer patients.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

• IgG4-RD can occur following dual ICI therapy, mimicking metastatic disease.
• Histologic examination is essential for accurate diagnosis of IgG4-RD.
• Rituximab was used in this case for IgG4-RD treatment.
• The patient showed radiologic stabilization/regression of renal lesions after rituximab treatment.
• Glucocorticoids may hinder antitumor immune surveillance.

Clinical Implications

IgG4-RD should be considered in patients with new renal lesions after ICI therapy. Histological confirmation is vital for diagnosis.

Conclusion

This case highlights IgG4-RD as a potential irAE of ICI therapy.

Related Resources & Content

1. Frontiers in Immunology, 2026 -- Rituximab is Associated with Accelerated Dialysis Independence in Anti-glomerular Basement Membrane Disease: A Retrospective Cohort Analysis of Renal Survival
2. Frontiers in Immunology, 2026 -- Recurrent spinal IgG4-related hypertrophic pachymeningitis and its management: a case report
3. Frontiers in Medicine, 2026 -- Purpura as the initial manifestation of IgG4-related disease with concomitant systemic lupus erythematosus: a case report
4. The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease | Annals of the Rheumatic Diseases
5. Efficacy and safety of rituximab induction therapy and effect of rituximab maintenance for IgG4-related disease: a systematic review and meta-analysis - ScienceDirect
6. Frontiers in Oncology — Sequential immune-related nephritis and pneumonitis during immune checkpoint inhibitor therapy: a case report
7. NCCN Guidelines® Insights: Management of Immunotherapy-Related Toxicities, Version 2.2024
8. The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease | Annals of the Rheumatic Diseases
9. Efficacy and safety of rituximab induction therapy and effect of rituximab maintenance for IgG4-related disease: a systematic review and meta-analysis - ScienceDirect