RATIONALE: BRAF and MEK inhibitors have significantly improved the prognosis of 
metastatic melanoma, by inhibiting both the mitogen-activated protein kinase 
(MAP-kinase) pathway. They are associated with infrequent adverse kidney events. 
Most of these are related to the use of BRAF inhibitors and involve interstitial 
nephritis with acute tubular necrosis.
PATIENT CONCERNS: We report a unique case of glomerulonephritis with renal 
granulomatous vasculitis in a patient diagnosed with metastatic melanoma treated 
with BRAF and MEK inhibitors. The patient was a 55-year old woman, who presented 
a melanoma of the right thigh with pulmonary metastasis. Treatment started in 
November 2015, with Encorafenib and Binimetinib, new BRAF and MEK inhibitors, 
respectively. Two months after the beginning of the treatment, there was a 
worsening of her renal function with significant proteinuria.
DIAGNOSES: Kidney biopsy showed extracapillary proliferation in the glomeruli 
with a granulomatous reaction.
INTERVENTIONS AND OUTCOMES: Renal function recovered completely after withdrawal 
of the chemotherapy.
LESSONS: All the reported kidney adverse events secondary to BRAF and MEK 
inhibitors in the literature are related to the use of BRAF inhibitors. Some 
previous reported mechanistic investigations also provide insight between BRAF 
inhibitors and podocytes injuries. Therefore, encorafenib most likely is the 
main responsible of the disease. However, evidence has emerged that inhibition 
of the MAP kinase pathway could also enhance autoimmunity. Thus, binimetinib may 
also have played a role and the combination of BRAF and MEK inhibitors may have 
facilitated this autoimmune kidney disease.