{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:08:01Z","timestamp":1763662081492,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The advent of immune checkpoint inhibitors (ICIs) represented a significant breakthrough in cancer therapy. Recently, the combined use of atezolizumab and bevacizumab was approved as first\u2010line treatment for unresectable hepatocellular carcinoma (HCC). Exposure to a novel and diverse spectrum of immune\u2010related adverse events (irAEs) has increased with the growing utilization of ICIs, however, a comprehensive understanding surrounding newer agents is still lacking. The incidence of kidney toxicities is rare but rising, often underreported due to the lack of confirmatory biopsies. Here, we present a rare case of biopsy\u2010proven acute interstitial nephritis (AIN) following atezolizumab\u2010bevacizumab treatment of advanced unresectable HCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>An 84\u2010year\u2010old male with T4N0M0 hepatocellular carcinoma was admitted after cycle 5 of atezolizumab due to decreased urine output and dysuria with a serum creatine of 4.7\u2009mg\/dL compared to a baseline of 1.3\u2009mg\/dL. To confirm the diagnosis of possible intrinsic renal injury, an ultrasound\u2010guided non\u2010focal biopsy of the left kidney was performed, revealing AIN. Potential exacerbatory medications, such as proton\u2010pump inhibitors, were discontinued. The patient was discharged on oral steroids with improvement in serum creatinine. Before completing the steroid taper, the patient developed pneumocystis pneumonia and eventually transitioned to hospice care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case highlights the valuable role renal biopsy can play in accurately capturing irAEs and guiding appropriate management in the setting of ICI\u2010induced AKI. It also exemplifies important considerations for steroid treatment of irAEs in the setting of comorbidities, such as diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.2110","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T11:04:57Z","timestamp":1721905497000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A case of <scp>biopsy\u2010proven<\/scp> acute interstitial nephritis following <scp>atezolizumab\u2010bevacizumab<\/scp> treatment of advanced unresectable hepatocellular carcinoma"],"prefix":"10.1002","volume":"7","author":[{"given":"Reema","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology\u2010Oncology University of Virginia  Charlottesville Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-8035","authenticated-orcid":false,"given":"Omar","family":"Elghawy","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Virginia  Charlottesville Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srishti","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Hematopathology University of California  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varinder","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology\u2010Oncology University of Virginia  Charlottesville Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29050247"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2017.08.005"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0000152019"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.12204"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0000852019"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3198"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1915745"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.11.030"},{"key":"e_1_2_10_10_1","article-title":"Acute tubulointerstitial nephritis associated with atezolizumab, an anti\u2010programmed death\u2010ligand 1 (pd\u2010l1) antibody therapy","volume":"7","author":"Xipell M","year":"2018","journal-title":"Onco Targets 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