scholarly journals Nivolumab-Induced Autoimmune Haemolytic Anaemia and Safety of Subsequent Use of Ipilimumab: A Case Report

2021 ◽  
pp. 1289-1294
Author(s):  
Anna Carbó-Bagué ◽  
Roser Fort-Culillas ◽  
Helena Pla-Juher ◽  
Jordi Rubió-Casadevall
Keyword(s):  
Adverse Event ◽  
Case Report ◽  
Haemolytic Anaemia ◽  
Checkpoint Inhibitors ◽  
Immune Surveillance ◽  
Subsequent Treatment ◽  
Autoimmune Haemolytic Anaemia ◽  
Adjuvant Setting ◽  
First Case ◽  
Inhibitor Treatment

Autoimmune haemolytic anaemia (AIHA) is a rare immune-related adverse event and appears to be more common with anti-PD1/PDL1 than anti-CTLA4. Little is known about the safety of re-treating with anti-PD1/PDL1 or changing to anti-CTLA4. We present a case of grade 4 AIHA due to nivolumab (PD1-inhibitor) treatment in a patient with melanoma for adjuvant setting after surgery and the safeness of subsequent treatment with ipilimumab (anti-CTLA4). After the remission of AIHA with steroids, ipilimumab was started with the rationale of its different mechanism of action. Fortunately, AIHA did not recur. The mechanism by which checkpoint inhibitors cause AIHA is likely by augmenting or redirecting immune surveillance, especially by activating pre-existing red blood cell autoantibodies, but further studies must be done. To our knowledge, this is the first case published in the literature with the change of immunotherapy treatment to anti-CTLA4.

scholarly journals Complications following breast cancer therapy in the adult spina bifida population: A case report

2013 ◽  
Vol 7 (11-12) ◽  
pp. 761
Author(s):  
Nathan Y Hoy ◽  
Peter Metcalfe
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Spina Bifida ◽  
Ileal Conduit ◽  
Subsequent Treatment ◽  
Breast Cancer Chemotherapy ◽  
Cancer Management ◽  
First Case ◽  
Breast Cancer Management ◽  
Neurogenic Bowel

Survival to adulthood in spina bifida has greatly increased with the advent of modern therapies. With this prolonging of life expectancy, patients are exposed to the risk of adult onset malignancies and the complications of subsequent treatment. We present the case of a 66-year-old woman born with a terminal lipomyelomeningocele, presenting with new fecal incontinence and a desire to undivert her ileal conduit. The deterioration was attributed to chemotherapy for breast cancer. We highlight the urologic challenges of breast cancer management in the neurogenic bowel population, as well as the utility of an adult spina bifida clinic. To the best of our knowledge, this is the first case report of a spina bifida patient presenting with fecal and urinary complications from breast cancer chemotherapy.

Bluish-gray fingernail discoloration due to the use of nivolumab

2020 ◽  
pp. 107815522092997
Author(s):  
Miguel Michel Ocampo ◽  
Jaren Lerner ◽  
Constantin A Dasanu
Keyword(s):  
Case Report ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Skin Toxicity ◽  
Unique Case ◽  
First Case ◽  
Nail Discoloration ◽  
Wide Range ◽  
Causality Relationship

Introduction Immune checkpoint inhibitors have improved clinical outcomes in a wide range of cancers. While skin toxicity is not uncommon with immune checkpoint inhibitors, generalized nail discoloration has not been reported with their use in oncology. Case report Herein, we report a unique case of bluish-gray fingernail discoloration due to nivolumab therapy for relapsed melanoma. Management and outcome: This condition reversed completely 10 weeks after nivolumab discontinuation. Naranjo nomogram assessment renders the causality relationship between nivolumab and nail discoloration probable. Discussion To our knowledge, this is the first case report of an unusual bluish-gray nail discoloration due to therapy with nivolumab. The mechanism by which nivolumab causes this side effect remains to be elucidated.

Myasthenia gravis with thymoma and autoimmune haemolytic anaemia. A case report

2003 ◽  
Vol 24 (1) ◽  
pp. 34-36 ◽  
Author(s):  
N. Tuncer Elmaci ◽  
S. Ratip ◽  
D. ?nce-G�nal ◽  
T. Tanrida?
Keyword(s):  
Case Report ◽  
Myasthenia Gravis ◽  
Haemolytic Anaemia ◽  
Autoimmune Haemolytic Anaemia

scholarly journals Pembrolizumab-induced autoimmune haemolytic anaemia and cholangitis

2019 ◽  
Vol 12 (12) ◽  
pp. e232505 ◽  
Author(s):  
Harriet Williams ◽  
Robin Aitchison
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Haemolytic Anaemia ◽  
De Novo ◽  
Checkpoint Inhibitors ◽  
Autoimmune Haemolytic Anaemia ◽  
Dermatological Disease ◽  
Wide Range ◽  
Life Threatening ◽  
Life Threatening Complication

Increasing numbers of patients are now offered immunotherapy as part of their cancer treatment. These treatments, while often very effective, have a wide range of adverse effects that are distinct from those of traditional chemotherapy regimens. Thyroid disease, dermatological disease, colitis and pneumonitis are some of the most commonly reported immune side effects. We present a case of life-threatening de novo autoimmune haemolytic anaemia (AIHA) complicated by immune cholangitis induced by pembrolizumab. An 81-year-old woman with metastatic melanoma completed a two-year course of pembrolizumab in August 2018 and six weeks later presented to hospital with jaundice. Admission haemoglobin (Hb) was 91 g/L, rapidly decreasing to 31 g/L, at which point she required admission to the intensive care unit. AIHA is a rare but potentially life-threatening complication of checkpoint inhibitors and should be considered in patients presenting with anaemia during or after immunotherapy treatment.

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