AUTHOR=Qureshi Sehrish , Arani Naszrin , Parvathareddy Vishnu , Tchakarov Amanda , Abdelrahim Maen , Suarez-Almazor Maria , Zhang Jianjun , Gibbons Don Lynn , Heymach John , Altan Mehmet , Abudayyeh Ala TITLE=Case Report: Immune checkpoint inhibitor–induced multiorgan vasculitis successfully treated with rituximab JOURNAL=Frontiers in Nephrology VOLUME=3 YEAR=2023 URL=https://www.frontiersin.org/journals/nephrology/articles/10.3389/fneph.2023.1168614 DOI=10.3389/fneph.2023.1168614 ISSN=2813-0626 ABSTRACT=

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer. ICIs have a unique side effect profile, generally caused by inflammatory tissue damage, with clinical features similar to autoimmune conditions. Acute kidney injury from ICIs has been well studied; incidence ranges from 1% to 5%, with higher incidence when combination ICI therapies are used. Although the overall reported incidence of ICI-associated glomerulonephritis is less than 1%, vasculitis is the most commonly reported ICI-related glomerulonephritis. Other biopsy findings include thrombotic microangiopathy, focal segmental glomerulosclerosis, minimal change disease, and IgA nephropathy with secondary amyloidosis. We report a case in which a woman previously treated with the PD-L1 inhibitor durvalumab for locally advanced non-small cell lung cancer with pre-existing antineutrophil cytoplasmic (anti-PR3) antibody who later developed multi-organ vasculitis after ICI exposure, which was successfully treated with rituximab, with continued cancer remission for 3 years.