A case of relapsing immunoglobulin A nephropathy secondary to immunotherapy

An estimated 3% of patients treated with immune checkpoint inhibitors develop acute kidney injury during the treatment course. The majority of biopsy-proven checkpoint inhibitor–associated nephropathy is related to acute interstitial nephritis, but various glomerulonephritides have been reported, including immunoglobulin A nephropathy and minimal change disease. Secondary immunoglobulin A nephropathy can be associated with autoimmune and infectious disease, but, unlike minimal change disease, rarely as a result of medications. To date, there are no clear evidences that treating secondary immunoglobulin A nephropathy or minimal change disease with immunosuppression therapy provides resolution for glomerulonephritis. We report the first case of remission of checkpoint inhibitor–induced overlap immunoglobulin A/minimal change disease nephropathy treated with repository corticotrophin therapy.