Authors of a recent case report described a man in his early 50s with extranodal NK/T-cell lymphoma who developed new-onset heavy proteinuria and worsening renal function shortly after starting a combination regimen that included the PD-1 inhibitor tislelizumab. Kidney biopsy showed IgA nephropathy with rapidly progressive glomerulonephritis, including diffuse proliferative and necrotizing changes and crescent formation. The PD-1 inhibitor was discontinued, and treatment with high-dose corticosteroids and cyclophosphamide led to partial renal recovery. By 12 months, the patient’s lymphoma was in complete remission, and the nephropathy had nearly resolved.
For those who care for patients receiving immune checkpoint inhibitors, the case highlights the importance of monitoring renal function throughout treatment, including serum creatinine, urinalysis, and proteinuria. Most immune-related kidney events involve acute interstitial nephritis, while glomerular disease such as IgA nephropathy is less common but can be clinically significant. Because this is a single-patient report, it cannot establish causality, but the authors note that new proteinuria or acute kidney injury during checkpoint inhibitor therapy should prompt early nephrology evaluation and consideration of kidney biopsy to help guide treatment decisions and reduce the risk of irreversible kidney injury.
Reference: Mohammadi N, Li F, Wang H, et al. Immune-Mediated IgA Nephropathy Induced by PD-1 Blockade in Extranodal NK/T-Cell Lymphoma. Int Med Case Rep J. 2026 Jun 9;19:593548. doi: 10.2147/IMCRJ.S593548.
Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC13264304/
