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We report the case of a man in his 60s receiving the ICI pembrolizumab for lung adenocarcinoma, who presented with acute renal failure requiring renal replacement therapy and was diagnosed with anti-GBM disease. This case highlights potentially important mechanistic links between lung cancer, immunotherapy and anti-GBM disease development. In line with previous research, there is evidence that breakdown of self-tolerance in response to ICIs may predispose patients to the development of autoimmune disease. In patients on ICIs presenting with acute renal failure, it is important to consider anti-GBM disease as an aetiology alongside more common acute tubulointerstitial nephritis seen in immune-related adverse events of the kidney.<\/jats:p>","DOI":"10.1136\/bcr-2025-271749","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:35:17Z","timestamp":1774532117000},"page":"e271749","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Anti-GBM glomerulonephritis in a patient with lung adenocarcinoma following pembrolizumab therapy"],"prefix":"10.1136","volume":"19","author":[{"given":"Radwa","family":"Abouelyazid","sequence":"first","affiliation":[{"name":"Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5141-6220","authenticated-orcid":false,"given":"Fred","family":"Fyles","sequence":"additional","affiliation":[{"name":"Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"},{"name":"University of Liverpool, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaw Min","family":"Tun","sequence":"additional","affiliation":[{"name":"Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asheesh","family":"Sharma","sequence":"additional","affiliation":[{"name":"Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"2026032606350974000_19.3.e271749.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-065X.2010.00923.x"},{"key":"2026032606350974000_19.3.e271749.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30607-1"},{"key":"2026032606350974000_19.3.e271749.3","unstructured":"DailyMed . 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