To report a case of sequential immune-related nephritis and pneumonitis during immune checkpoint inhibitor therapy, emphasizing the complexities and clinical implications of managing these adverse events.
Key Findings:
The patient experienced severe acute kidney injury with a significant increase in serum creatinine, indicating immune-related nephritis.
High-dose corticosteroids led to rapid recovery of kidney function, but subsequent tapering resulted in the development of immune-related pneumonitis.
Re-escalation of corticosteroids during pneumonitis led to rapid improvement, highlighting the need for careful management of corticosteroid dosing.
Interpretation:
This case illustrates the dynamic and sequential nature of immune-related adverse events, emphasizing the need for close monitoring and timely adjustments in treatment during corticosteroid tapering to prevent further complications.
Limitations:
The case study is based on a single patient, limiting generalizability.
The variability in clinical courses of irAEs complicates understanding and management.
Lack of follow-up data on long-term outcomes post-treatment.
Conclusion:
Immune-related nephritis and pneumonitis can occur sequentially during ICI therapy, necessitating vigilant monitoring and personalized treatment approaches even after initial resolution of symptoms.
