Clinical Report: Concurrent Immune-Related Nephritis and Pneumonitis Following ICI Treatment

Overview

Revise to emphasize the sequential nature of irAEs and the importance of management strategies.

Background

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but can lead to immune-related adverse events (irAEs) affecting various organ systems. Immune-related nephritis and pneumonitis are significant complications that can result in severe morbidity and mortality. Understanding the sequential nature of these irAEs is crucial for optimizing patient management and improving outcomes.

Data Highlights

No numerical data available in the article.

Key Findings

• The patient developed severe acute kidney injury indicative of immune-related nephritis during ICI therapy.
• High-dose corticosteroids led to rapid recovery of kidney function, followed by a gradual taper.
• As corticosteroid dosage was reduced, the patient developed fever and respiratory symptoms, indicating immune-related pneumonitis.
• Re-escalation of corticosteroids resulted in rapid improvement of pneumonitis symptoms.
• This case illustrates the dynamic nature of irAEs and the potential for new immune-mediated toxicities to emerge during steroid tapering.

Clinical Implications

Healthcare professionals should maintain vigilance for the emergence of new irAEs during corticosteroid tapering in patients receiving ICIs. Prompt recognition and management of these adverse events are essential to prevent severe complications and ensure optimal patient outcomes.

Conclusion

This case underscores the importance of continuous monitoring and individualized treatment approaches for managing sequential immune-related adverse events in patients undergoing ICI therapy.

Related Resources & Content

1. Naqash et al., The ASCO Post, 2022 -- Incidence of Major Adverse Cardiac Events in Patients Receiving Immune Checkpoint Inhibitors
2. Shankar et al., The ASCO Post, 2020 -- Multisystem Immune-Related Adverse Events and Disease Outcomes Among Patients With NSCLC Treated With Immunotherapy
3. The ASCO Post, 2025 -- Studies Explore Cardiac Risks and Clinical Characteristics Associated With Immune Checkpoint Inhibitor–Related Myocarditis
4. The ASCO Post — Do HIV Positivity and Autoimmune Disease Preclude Treatment With Checkpoint Inhibitors?
5. Advances in the mechanisms, imaging characteristics and management strategies for immune checkpoint inhibitor-related pneumonitis
6. Incidence of pneumonitis with CTLA-4 inhibitors in non-small cell lung cancer: a systematic review and meta-analysis
7. Urinary C-X-C-motif ligand 9 (CXCL9) in immune checkpoint inhibitor-associated acute interstitial nephritis