Diffuse alveolar hemorrhage with nivolumab monotherapy

Vickie R. Shannon; Sumit K. Subudhi; Lei Huo; Saadia A. Faiz

doi:10.1016/j.rmcr.2020.101131

Diffuse alveolar hemorrhage with nivolumab monotherapy

Vickie R. Shannon, Sumit K. Subudhi, Lei Huo, Saadia A. Faiz

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

We describe a 60 year old man who developed respiratory insufficiency after treatment with 2 rounds of nivolumab monotherapy. Imaging revealed subtle ground glass infiltrates which progressed to diffuse opacities and consolidation. The patient was treated with high dose corticosteroids, empiric antimicrobial therapy and infliximab. Bronchoscopy with lavage revealed negative cultures and progressive bloody aliquots of fluid consistent with diffuse alveolar hemorrhage. The patient succumbed to respiratory failure. An autopsy study confirmed extensive alveolar hemorrhage. Our reports highlights clinical and diagnostic findings with immunotherapy-induced pneumonitis.

Original language	English (US)
Article number	101131
Journal	Respiratory Medicine Case Reports
Volume	30
DOIs	https://doi.org/10.1016/j.rmcr.2020.101131
State	Published - 2020

Keywords

Cancer
Diffuse alveolar hemorrhage
Drug-induced pneumonitis
Immune checkpoint inhibitor
Immunotherapy

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

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10.1016/j.rmcr.2020.101131

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title = "Diffuse alveolar hemorrhage with nivolumab monotherapy",

abstract = "We describe a 60 year old man who developed respiratory insufficiency after treatment with 2 rounds of nivolumab monotherapy. Imaging revealed subtle ground glass infiltrates which progressed to diffuse opacities and consolidation. The patient was treated with high dose corticosteroids, empiric antimicrobial therapy and infliximab. Bronchoscopy with lavage revealed negative cultures and progressive bloody aliquots of fluid consistent with diffuse alveolar hemorrhage. The patient succumbed to respiratory failure. An autopsy study confirmed extensive alveolar hemorrhage. Our reports highlights clinical and diagnostic findings with immunotherapy-induced pneumonitis.",

keywords = "Cancer, Diffuse alveolar hemorrhage, Drug-induced pneumonitis, Immune checkpoint inhibitor, Immunotherapy",

author = "Shannon, {Vickie R.} and Subudhi, {Sumit K.} and Lei Huo and Faiz, {Saadia A.}",

note = "Funding Information: This research is supported in part by the National Institutes of Health through MD Anderson's Cancer Center Support Grant ( CA016672 ). Publisher Copyright: {\textcopyright} 2020",

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AU - Subudhi, Sumit K.

AU - Huo, Lei

AU - Faiz, Saadia A.

PY - 2020

Y1 - 2020

N2 - We describe a 60 year old man who developed respiratory insufficiency after treatment with 2 rounds of nivolumab monotherapy. Imaging revealed subtle ground glass infiltrates which progressed to diffuse opacities and consolidation. The patient was treated with high dose corticosteroids, empiric antimicrobial therapy and infliximab. Bronchoscopy with lavage revealed negative cultures and progressive bloody aliquots of fluid consistent with diffuse alveolar hemorrhage. The patient succumbed to respiratory failure. An autopsy study confirmed extensive alveolar hemorrhage. Our reports highlights clinical and diagnostic findings with immunotherapy-induced pneumonitis.

AB - We describe a 60 year old man who developed respiratory insufficiency after treatment with 2 rounds of nivolumab monotherapy. Imaging revealed subtle ground glass infiltrates which progressed to diffuse opacities and consolidation. The patient was treated with high dose corticosteroids, empiric antimicrobial therapy and infliximab. Bronchoscopy with lavage revealed negative cultures and progressive bloody aliquots of fluid consistent with diffuse alveolar hemorrhage. The patient succumbed to respiratory failure. An autopsy study confirmed extensive alveolar hemorrhage. Our reports highlights clinical and diagnostic findings with immunotherapy-induced pneumonitis.

KW - Cancer

KW - Diffuse alveolar hemorrhage

KW - Drug-induced pneumonitis

KW - Immune checkpoint inhibitor

KW - Immunotherapy

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JO - Respiratory Medicine Case Reports

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ER -

Diffuse alveolar hemorrhage with nivolumab monotherapy

Abstract

Keywords

ASJC Scopus subject areas

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