{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:05:23Z","timestamp":1787843123926,"version":"build-2784847793"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    Immune checkpoint inhibitors (ICIs) have revolutionized the management of gastric cancer; however, they can lead to rare immune-related adverse events (irAEs) affecting the urinary system. Herein, we report a case of non-bacterial cystitis complicated by acute kidney injury (AKI) in a 59-year-old male patient with Alpha-fetoprotein-producing gastric carcinoma (AFP-GC). Following treatment with toripalimab combined with SOX chemotherapy, the patient developed urinary tract irritation symptoms, gross hematuria, and stage II AKI. Cystoscopy revealed diffuse mucosal hemorrhage, and biopsy demonstrated extensive infiltration of CD3\n                    <jats:sup>+<\/jats:sup>\n                    , CD8\n                    <jats:sup>+<\/jats:sup>\n                    , CD4\n                    <jats:sup>+<\/jats:sup>\n                    , and CD20\n                    <jats:sup>+<\/jats:sup>\n                    lymphocytes, along with high PD-L1 expression and TIA-1 positivity, confirming the diagnosis of non-bacterial cystitis. A full-dose methylprednisolone pulse of 200 mg\/day effectively alleviated the symptoms and restored renal function. This case underscores the importance of vigilance for urinary system irAEs in patients receiving ICIs, emphasizing that early identification and systematic evaluation are critical. Full-dose corticosteroids should be used for moderate to severe irAEs. Moreover, this report provides valuable insights into immunotherapy practice and toxicity management in the rare AFP-GC subtype.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1836979","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:37:18Z","timestamp":1784007438000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Non-bacterial cystitis following treatment with toripalimab for alpha-fetoprotein-producing gastric adenocarcinoma: a case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhenpeng","family":"Li","sequence":"first","affiliation":[{"name":"First Clinical Medical College of Shandong University of Traditional Chinese Medicine","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuxiu","family":"Yi","sequence":"additional","affiliation":[{"name":"Weifang Municipal Hospital of Traditional Chinese Medicine","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Fu","sequence":"additional","affiliation":[{"name":"Weifang Municipal Hospital of Traditional Chinese Medicine","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liang","sequence":"additional","affiliation":[{"name":"Weifang Municipal Hospital of Traditional Chinese Medicine","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sensen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Weifang Municipal Hospital of Traditional Chinese Medicine","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xv","family":"Yang","sequence":"additional","affiliation":[{"name":"Weifang Municipal Hospital of Traditional Chinese Medicine","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhonghai","family":"Du","sequence":"additional","affiliation":[{"name":"Weifang Municipal Hospital of Traditional Chinese Medicine","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21657","article-title":"Current treatment and recent progress in gastric cancer","volume":"71","author":"Joshi","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(24)00278-x","article-title":"Multi-organ immune-related adverse events from immune checkpoint inhibitors and their downstream implications: a retrospective multicohort study","volume":"25","author":"Wan","year":"2024","journal-title":"Lancet Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.2147\/ott.s321965","article-title":"Immunotherapy-related cystitis: case report and review of the literature","volume":"14","author":"Zhu","year":"2021","journal-title":"Onco Targets Ther"},{"key":"B4","article-title":"existence of alpha feto protein during gastric-origin secondary cancer of the liver","volume":"78","author":"Bourreille","year":"1970","journal-title":"Presse Med (1893)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850815)56:4<840::aid-cncr2820560423>3.0.co;2-e","article-title":"An AFP-producing gastric carcinoma with features of hepatic differentiation. 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