Diagnostic tests in acute renal insufficiency after checkpoint inhibitors
| 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 |
Data in boldface represent abnormal results