Nivolumab‐induced acute tubular injury: A case report

Abstract

Nivolumab belongs to immune checkpoint inhibitors (ICIs). ICIs‐induced kidney injury is rare and acute interstitial nephritis (AIN) is the majority. A 58‐year‐old woman had gastric cancer treated with nivolumab. Her serum creatinine (Cr) increased to 5.94 mg/dL post 2 cycles of nivolumab and co‐administered with acemetacin. A kidney biopsy showed acute tubular injury (ATI). Nivolumab rechallenge was done and Cr worsened again. The lymphocyte transformation test (LTT) indicated a strong positive for nivolumab. Although rare, ATI due to ICIs could not be ruled out, and LTT is a tool to identify the culprit.