Immune-related nephritis, ureteritis and cystitis secondary to immune checkpoint inhibitors: A case report and review of the literature
Abstract
Immune checkpoint inhibitors (ICIs) have beneficially impacted cancer therapy but are frequently associated with immune-related adverse events (irAEs), most commonly affecting the skin and gastrointestinal system. By contrast, genitourinary toxicities are rare and often underrecognized. The present case report outlines a 62-year-old male with metastatic colorectal cancer who developed pan-urinary tract irAEs (concurrent immune-related nephritis, ureteritis and cystitis) after exposure to three distinct classes of ICIs. The patient initially experienced pollakiuria, urinary urgency, dysuria and hematuria, which worsened after switching to cadonilimab and adebrelimab. This deterioration coincided with rising serum creatinine levels and lack of improvement with antibacterial treatment. Urinalysis revealed leukocyturia and hematuria, while imaging demonstrated bilateral hydroureteronephrosis and diffuse bladder wall thickening. A multidisciplinary evaluation led to the diagnosis of ICI-induced pan-urinary tract irAEs. Both urinary symptoms and renal function resolved rapidly after halting immunotherapy and starting glucocorticoid treatment, with no recurrence during follow-up. In addition, a comprehensive review of reported cases was conducted to characterize this rare irAE presentation and further propose both diagnostic criteria and management strategies to facilitate early detection and effective treatment.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.