An Extremely Rapid Case of Pneumonitis with the Use of Nivolumab for Pancreatic Adenocarcinoma.
Rubens Barros CostaAl BensonVahid YaghmaiRicardo L B CostaHaijun ZhouAmir BehdadJason B KaplanMaureen SadimSarah TalamantesAparna KalyanPublished in: Case reports in oncological medicine (2018)
Pancreatic cancer is the fourth most common cancer death in the United States despite comprising a small percentage of the total number of cancer cases. The estimated 5-year overall survival (OS) for patients with distant metastatic disease is approximately 3%. New treatment options are an unmet need and remain an area of active investigation. A 53-year-old male with metastatic pancreatic cancer presented to the hospital with acute-on-chronic respiratory failure approximately 24 hours after receiving a novel therapeutic combination. Chest imaging showed marked changes as concerning for pneumonitis. Infectious workup was negative. The patient had initial clinical improvement after receiving initial intravenous steroids and oxygen support but eventually deteriorated later opting for supportive measures only. With infection ruled out, drug-induced pneumonitis was felt to be the likely cause of the radiologic and clinical changes. The rapidity of onset of symptoms is the aspect being highlighted in this case.
Keyphrases
- drug induced
- respiratory failure
- liver injury
- papillary thyroid
- small cell lung cancer
- squamous cell carcinoma
- extracorporeal membrane oxygenation
- squamous cell
- interstitial lung disease
- mechanical ventilation
- adverse drug
- healthcare
- high resolution
- liver failure
- lymph node
- systemic sclerosis
- case report
- lymph node metastasis
- rheumatoid arthritis
- emergency department
- intensive care unit
- mass spectrometry
- depressive symptoms
- low dose
- physical activity
- quantum dots