Linear IgA Disease of the Gingiva Following Nivolumab Therapy

J Immunother. 2019 Nov/Dec;42(9):345-347. doi: 10.1097/CJI.0000000000000288.

Abstract

Immunotherapy has advanced the treatment of solid organ malignancies. Although generally well tolerated, treatment with immune checkpoint inhibitors can be complicated by immune-related adverse events, some of which are relatively uncommon. We report the first case of gingival linear immunoglobulin A disease related to treatment with an antiprogrammed cell death protein 1 antibody. A 73-year-old male with advanced non-small cell lung cancer achieved a durable response to nivolumab monotherapy. After 1 year of treatment, he developed gingival swelling and pain. Biopsy revealed linear immunoglobulin A disease of the gingiva which was effectively treated with systemic steroids. Ongoing vigilance for immune-mediated toxicity is paramount during and after treatment with immune checkpoint inhibitors.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents, Immunological / adverse effects*
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Gingival Diseases / etiology*
  • Humans
  • Immunoglobulin A*
  • Lung Neoplasms / drug therapy
  • Male
  • Nivolumab / adverse effects*

Substances

  • Antineoplastic Agents, Immunological
  • Immunoglobulin A
  • Nivolumab