Pembrolizumab-associated minimal change disease in a patient with malignant pleural mesothelioma

BMC Cancer

Case Report

Lukas Flatz¹  Angelika Bickel²  Martin Früh²  Irene Koneth³  Jörg Neuweiler⁴  Annette Enzler-Tschudy⁴ 

[1] Department of Dermatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;Department of Oncology and Haematology, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland;Division of Nephrology and Transplantation Medicine, Cantonal Hospital St.Gallen, St. Gallen, Switzerland;Institute of Pathology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;

关键词: Malignant Pleural Mesothelioma;    PD-1 antibody;    Pembrolizumab;    Immunotherapy;    Minimal change disease;   

DOI  :  10.1186/s12885-016-2718-y

 received in 2016-04-28, accepted in 2016-08-14,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPembrolizumab is an anti- Programmed Death 1 (PD-1) antibody approved in melanoma, non-small cell lung cancer and investigated in malignant pleural mesothelioma.The most frequent immunotherapy related autoimmune reactions include dermatitis, pneumonitis, colitis, hypophysitis, uveitis, hypothyreodism, hepatitis and interstitial nephritis.Case presentationWe describe a 62-year old patient diagnosed with malignant pleural mesothelioma who experienced ten days after the second dose of third line therapy with pembrolizumab sudden onset of generalized edema including legs and eyelids and weight gain of 15 kg resulting from nephrotic syndrome and acute renal failure. Pembrolizumab was discontinued and prednisone, diuretics and angiotensin II receptor blocker were initiated with full recovery of symptoms and renal function. Pembrolizumab-associated minimal change disease (MCD) was confirmed by electron microscopy in the renal biopsy.ConclusionWe are the first to describe pembrolizumab-related minimal change disease (MCD).Physicians should be aware of this side effect in patients presenting with edema and weight gain and initiate prompt renal function testing, serum albumin and urinalysis followed by steroid treatment if pembrolizumab-related MCD is suspected.

【 授权许可】

CC BY   
© The Author(s). 2016