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Table 1 Diagnostic tests in acute renal insufficiency after checkpoint inhibitors

From: Interstitial nephritis in melanoma patients secondary to PD-1 checkpoint inhibitor

  Case 1 (male) Case 2 (female) Reference range
Serology
 ANA titer <40 <40 Negative
 CRP 97 37.9 0–3.0
 ESR 123 50 0–30
 ASO 47 32 <200
 Anti dsDNA by EIA 7 19 Negative
 ANCA SCR W/MPO/PR3 W/REFLEX Negative Negative Negative
 ANA screen - serum Negative Positive Negative
 Kappa Light Chains Free light chains 65.26 30.59 3.3–19.4
 Lambda light chain, free 29.59 19.03 5.7–26.3
 Kappa/ Lambda free 2.45 0.26–1.65 1.61
 Hepatitis profile – Acute panel Negative Negative Negative
 HAV IgM, HCV Ab, ABB Core IGM, HBV Surface AG
 RPR Non-reactive Non-reactive Non-reactive
 SM/RNP Antibodies <0.1 <0.1 <0.1
 SM Antibodies <0.1 <0.1 <0.1
 CPK 38 35 26–192
 C3 149 150 90–180
 C4 39.8 46.5 10.0–40.0
 Uric Acid 6.5 9.5 2.6–6
 Vitamin D 25 13.6 32.6 30–100
 PTH intact 105.6 79.2 11.1–79.5
 Calcium 8.9 8.9 8.5–10.1
Protein electrophoresis with immunofixation
 Protein total 7.8 6.8 6.4–8.2 g/dl
 Albumin 3.72 4.53 3.57–5.42 g/gl
 Alpha 1 0.66 0.46 0.19–0.4 g/dl
 Alpha 2 1.44 1.11 0.45–0.97 g/dl
 Beta 1 0.47 0.44 0.3–0.59 g/dl
 Beta 2 0.56 0.46 0.21–0.53 g/dl
 Gamma 0.94 0.79 0.71–1.54 g/dl
Urinalysis
 Color Straw Yellow Yellow
 Turbidity Slightly cloudy Clear Clear
 Glucose Negative Negative Negative
 Bilirubin Negative Negative Negative
 Ketones Negative Negative Negative
 pH 6.0 6.5 4.5–8
 Protein Negative Negative Negative
 Specific gravity 1.005 1.01 Up to 1.035
 Blood Small Negative Negative
 Urobilinogen Negative 0.2 Negative
 Nitrites Negative Negative Negative
 Leukocyte esterase Large Negative Negative
 WBC, UA 38 Negative Negative
 RBC, UA 3 Negative Negative
 UBAC +1 Negative Negative
 Budding Yeast Present Negative Negative
 White blood cell clump Present Negative Negative
  1. Data in boldface represent abnormal results