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Case Report: THSD7A-Positive Membranous Nephropathy Caused by Tislelizumab in a Lung Cancer Patient

Immune checkpoint inhibitors (ICIs) became the standard treatment for many different kinds of cancers and can result in a variety of immune-related adverse events (irAEs). IrAEs of kidney are uncommon and consists of different pathology types. Among the different types, membranous nephropathy (MN) i...

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Autores principales: Chen, Minjiang, Zhang, Lei, Zhong, Wei, Zheng, Ke, Ye, Wei, Wang, Mengzhao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141750/
https://www.ncbi.nlm.nih.gov/pubmed/34040602
http://dx.doi.org/10.3389/fimmu.2021.619147
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author Chen, Minjiang
Zhang, Lei
Zhong, Wei
Zheng, Ke
Ye, Wei
Wang, Mengzhao
author_facet Chen, Minjiang
Zhang, Lei
Zhong, Wei
Zheng, Ke
Ye, Wei
Wang, Mengzhao
author_sort Chen, Minjiang
collection PubMed
description Immune checkpoint inhibitors (ICIs) became the standard treatment for many different kinds of cancers and can result in a variety of immune-related adverse events (irAEs). IrAEs of kidney are uncommon and consists of different pathology types. Among the different types, membranous nephropathy (MN) is rare and have not been well-described. Since MN can also be associated with malignancies, differential diagnosis in patients receiving ICIs who develop MN can be very difficult. We present the case of a 74-year-old man with metastatic non-small cell lung cancer who developed MN after ICIs therapy. The patient tested positive for thrombospondin type-1 domain-containing 7A antibodies (THSD7A) when diagnosed with MN. Supplementary examinations revealed the predisposing antigen in the primary tumor and present of the antibody after immunotherapy, which corresponded to the patient’s clinical course of nephropathy. Treatment consisting of systemic glucocorticoids and rituximab resulted in a good clinical response, and the THSD7A antibodies were no longer detected. In this case, we first discuss the potential mechanism of immunotherapy related MN, in which the activation of humoral immunity may play an important role.
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spelling pubmed-81417502021-05-25 Case Report: THSD7A-Positive Membranous Nephropathy Caused by Tislelizumab in a Lung Cancer Patient Chen, Minjiang Zhang, Lei Zhong, Wei Zheng, Ke Ye, Wei Wang, Mengzhao Front Immunol Immunology Immune checkpoint inhibitors (ICIs) became the standard treatment for many different kinds of cancers and can result in a variety of immune-related adverse events (irAEs). IrAEs of kidney are uncommon and consists of different pathology types. Among the different types, membranous nephropathy (MN) is rare and have not been well-described. Since MN can also be associated with malignancies, differential diagnosis in patients receiving ICIs who develop MN can be very difficult. We present the case of a 74-year-old man with metastatic non-small cell lung cancer who developed MN after ICIs therapy. The patient tested positive for thrombospondin type-1 domain-containing 7A antibodies (THSD7A) when diagnosed with MN. Supplementary examinations revealed the predisposing antigen in the primary tumor and present of the antibody after immunotherapy, which corresponded to the patient’s clinical course of nephropathy. Treatment consisting of systemic glucocorticoids and rituximab resulted in a good clinical response, and the THSD7A antibodies were no longer detected. In this case, we first discuss the potential mechanism of immunotherapy related MN, in which the activation of humoral immunity may play an important role. Frontiers Media S.A. 2021-05-10 /pmc/articles/PMC8141750/ /pubmed/34040602 http://dx.doi.org/10.3389/fimmu.2021.619147 Text en Copyright © 2021 Chen, Zhang, Zhong, Zheng, Ye and Wang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Chen, Minjiang
Zhang, Lei
Zhong, Wei
Zheng, Ke
Ye, Wei
Wang, Mengzhao
Case Report: THSD7A-Positive Membranous Nephropathy Caused by Tislelizumab in a Lung Cancer Patient
title Case Report: THSD7A-Positive Membranous Nephropathy Caused by Tislelizumab in a Lung Cancer Patient
title_full Case Report: THSD7A-Positive Membranous Nephropathy Caused by Tislelizumab in a Lung Cancer Patient
title_fullStr Case Report: THSD7A-Positive Membranous Nephropathy Caused by Tislelizumab in a Lung Cancer Patient
title_full_unstemmed Case Report: THSD7A-Positive Membranous Nephropathy Caused by Tislelizumab in a Lung Cancer Patient
title_short Case Report: THSD7A-Positive Membranous Nephropathy Caused by Tislelizumab in a Lung Cancer Patient
title_sort case report: thsd7a-positive membranous nephropathy caused by tislelizumab in a lung cancer patient
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141750/
https://www.ncbi.nlm.nih.gov/pubmed/34040602
http://dx.doi.org/10.3389/fimmu.2021.619147
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