Sequential immune-related nephritis and pneumonitis during immune checkpoint inhibitor therapy: a case report
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By
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Haocheng Zhao
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Shanshan Lin
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Lingzhi Wu
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Wenqiu Wu
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May 13, 2026
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Clinical Scorecard: Concurrent Immune-Related Nephritis and Pneumonitis Following Immune Checkpoint Inhibitor Treatment: A Case Study
At a Glance
| Category | Detail |
|---|
| Condition | Immune-related nephritis and pneumonitis |
| Key Mechanisms | T-cell–mediated inflammation and loss of peripheral immune tolerance |
| Target Population | Patients receiving immune checkpoint inhibitors (ICIs) for cancer treatment |
| Care Setting | Oncology and nephrology settings |
Key Highlights
- Immune-related nephritis occurs in approximately 2%-5% of ICI patients.
- Immune-related pneumonitis occurs in approximately 3%-5% of ICI patients.
- Sequential irAEs can develop during corticosteroid tapering.
- High-dose corticosteroids can lead to rapid recovery from nephritis.
- Close monitoring is essential for managing complex irAEs.
Guideline-Based Recommendations
Diagnosis
- Early detection of irAEs is crucial.
- Diagnosis should consider temporal association with ICI therapy.
Management
- Initiate systemic corticosteroids for moderate to severe irAEs.
- Re-escalate corticosteroids if new irAEs develop during tapering.
Monitoring & Follow-up
- Regular monitoring of renal function and clinical stability during treatment.
Risks
- Potential for serious morbidity and mortality from severe irAEs.
Patient & Prescribing Data
70-year-old man with gastroesophageal junction adenocarcinoma
Methylprednisolone was used for managing severe immune-related nephritis and pneumonitis.
Clinical Best Practices
- Maintain vigilance for new irAEs during corticosteroid tapering.
- Personalize immunosuppressive approaches based on clinical signs.
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