Nivolumab-induced Myocarditis Successfully Treated with Corticosteroid Therapy: A Case Report and Review of the Literature

Intern Med. 2019 Aug 15;58(16):2367-2372. doi: 10.2169/internalmedicine.2596-18. Epub 2019 May 22.

Abstract

A 62-year-old man presented to our hospital for the further evaluation and treatment of his back pain, general fatigue, and dyspnea, which had developed 4 days after the 29th administration of nivolumab to treat his lung cancer. Based on his clinical history, elevated serum cardiac enzyme values, and cardiac magnetic resonance (CMR) imaging and myocardial biopsy findings, he was diagnosed with myocarditis induced by nivolumab. Corticosteroid therapy improved his condition, and CMR performed on hospital day 11 also showed remarkable improvement. Although nivolumab-induced myocarditis is rare, cardiologists should consider it when encountering patients treated with such a drug for malignant disease.

Keywords: cardiac magnetic resonance imaging; corticosteroid; lung cancer; myocarditis; nivolumab.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Biopsy
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / physiopathology*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Myocarditis / drug therapy*
  • Myocarditis / etiology*
  • Nivolumab / adverse effects*
  • Nivolumab / therapeutic use*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Antineoplastic Agents, Immunological
  • Nivolumab