免疫检查点抑制剂 (ICI) 相关的免疫性肾炎或急性间质性肾炎 (AIN) 是 ICI 治疗罕见但已知的并发症之一。指南建议使用类固醇治疗 ICI 相关 AIN，然后使用 TNF-α 抑制剂英夫利昔单抗。然而，有些病例对这些疗法无效，可能是由于细胞因子阻断不足。这是首例患有转移性肺腺癌、需要高维持剂量类固醇治疗免疫性肾炎的 65 岁女性接受托法替布（一种口服 Janus 激酶 (JAK) 抑制剂）治疗的病例。托法替布成功实现了类固醇逐渐减量，并可能成为难治性免疫性肾炎的一种治疗选择。© 作者 2024。由牛津大学出版社代表 ERA 出版。

Immune checkpoint inhibitor (ICI)-associated immune nephritis or acute interstitial nephritis (AIN) is one of the rare but known complication of ICI therapy. Guidelines recommend treatment of ICI-associated AIN with steroids, then TNF-alpha inhibitor infliximab. However, some cases are refractory to these therapies, potentially due to insufficient cytokine blockade. This is the first case where a 65-year-old female with metastatic lung adenocarcinoma, requiring high maintenance doses of steroids for immune nephritis was treated with tofacitinib, an oral Janus kinase (JAK) inhibitor. Tofacitinib enabled successful steroid tapering and might be a therapy option for refractory immune nephritis.© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.