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Acute tubulointerstitial nephritis and renal amyloidosis: A rare complication of Atezolizumab

Updated: Dec 10, 2024

First author: Naqib Ullah

Journal: Cureus

Reference : DOI : 10.7759/cureus.49533


Article sur Néphrite tubulointerstitielle aiguë et amylose rénale

Introduction:

Lung cancer is the second most common malignancy. The two types of lung cancer are small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC). Among current treatments, anti-PD-1 or anti-PD-L1 agents (checkpoint inhibitors (PKIs): pembrolizumab and atezolizumab) represent adjuvant therapy in lung cancer. The most frequently reported adverse events with ICPs are diarrhea, pneumopathy and drug-induced hepatitis.


The authors report here the case of a 70-year-old man who received Atezolizumab as adjuvant therapy and developed nephrotic-like proteinuria, revealing AA amyloidosis and atezolizumab-induced interstitial nephritis.



 
 
 

Anakinra-Associated Systemic Amyloidosis

Updated: Dec 10, 2024

First author: S Alehashemi

Journal : Arthritis and Rheumatology

Reference : DOI : 10.1002/art.42664


ree

This article reports the first case of iatrogenic systemic amyloidosis due to prolonged use of anakinra, an interleukin-1 receptor antagonist (IL-1Ra), in a patient suffering from multisystem inflammatory disease of neonatal onset (NOMID).


After several years of treatment with daily injections, the patient developed nodules at the injection site, a nephrotic syndrome and amyloid deposits in various organs (skin, kidney, stomach). Mass spectrometry analysis identified these deposits as being due to recombinant anakinra protein, distinct from the endogenous version.


This case highlights a rare complication of injectable biologic treatments, exacerbated by high and prolonged doses. It highlights the importance of monitoring serum protein levels, varying injection sites, and considering a change of therapy if anakinra-related amyloidosis is diagnosed.



 
 
 
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