Diffuse alveolar hemorrhage with nivolumab monotherapy. (2020)

• Record Type: Journal Article
• Authors: Shannon, Vickie R.; Subudhi, Sumit K.; Huo, Lei; Faiz, Saadia A.
• Is Part Of: Respiratory medicine case reports. Volume 30(2020)
• Publication Date: 2020
• Subjects: Drug-induced pneumonitis -- Diffuse alveolar hemorrhage -- Immune checkpoint inhibitor -- Immunotherapy -- Cancer; Respiratory organs -- Diseases -- Periodicals; Chest -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System -- Periodicals; Chest -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; 616.2
• DOI: 10.1016/j.rmcr.2020.101131
• Languages: English
• ISSNs: 2213-0071

Abstract

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.