Case report of nivolumab-related pneumonitis

Immunotherapy. 2017 Mar;9(4):313-318. doi: 10.2217/imt-2016-0129.

Abstract

We report a case with suggestive antiprogrammed death-1 inhibitor-related pneumonitis in an endometrial cancer patient. This case presented with fever and cough after three dosages of nivolumab. Computed tomography initially showed centrilobular nodularities in a unilateral lung, which was compatible with aspiration pneumonia. However, diffuse ground-glass opacities (GGO) rapidly developed in the unilateral lung over 4 days despite the use of broad-spectrum antibiotics. Development of GGO was considered to be related to a nivolumab-mediated immune reaction. Corticosteroid was administered and the GGO subsequently disappeared. The present report focuses on the computed tomography diagnostic features of nivolumab-related pneumonitis. The accumulation of knowledge regarding various types of antiprogrammed death-1-related pneumonitis will lead to appropriate treatment for this newly emerging adverse event.

Keywords: PD-1 inhibitor; immune-related pneumonitis; nivolumab.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / pathology
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Drug-Related Side Effects and Adverse Reactions / diagnosis*
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Endometrial Neoplasms / drug therapy*
  • Endometrial Neoplasms / pathology
  • Female
  • Humans
  • Immunotherapy / adverse effects
  • Immunotherapy / methods*
  • Lung / diagnostic imaging
  • Lung / pathology*
  • Lymphocytes / immunology
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Neoplasm Metastasis
  • Nivolumab
  • Pneumonia / diagnosis*
  • Pneumonia / etiology
  • Pneumonia / prevention & control
  • Programmed Cell Death 1 Receptor / immunology
  • Tomography, X-Ray Computed

Substances

  • Antibodies, Monoclonal
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Nivolumab
  • Methylprednisolone