| Autor: |
Tommy Hammer, Rune Mo, Jarle Karlsen, Terese Louise Schmidberger Karlsen |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
Tidsskrift for Den norske legeforening. |
| ISSN: |
0029-2001 |
| Popis: |
Background Immunotherapy is used to treat several cancer types. As it is a relatively new type of treatment, knowledge of optimal handling of rare side effects is sparse. Case presentation A woman in her early eighties with inoperable metastases from malignant melanoma was given immunotherapy. Five weeks after the first dose of nivolumab 480 mg she was admitted to the hospital with symptoms of coronary artery disease. On suspicion of side effects from nivolumab, she was given prednisolone 80 mg daily. MRI of the heart showed findings highly suggestive of myocarditis. Her condition initially improved, but 9 days after leaving the hospital she developed muscular weakness and ptosis. Neurography and electromyography revealed acute axonal polyneuropathy and she was treated with mycophenolate mofetil. In the days that followed she had increasing paresis, apnoea and pain in the right shoulder. Echocardiography showed reduced systolic function. The patient died 11 days after the second hospitalisation. Interpretation The patient developed hepatitis, myocarditis and neuropathy after only one course of immunotherapy. Those are known to be rare side effects with a high mortality rate. The patient was given high dose prednisolone and mycophenolate mofetil. Intravenous immunoglobulins and/or plasmapheresis could have been alternative treatments. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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