BACKGROUND Immune checkpoint inhibitors have significantly improved survivals for an increasing range of malignancies but at the cost of several immune-related adverse events,the management of which can be challenging...BACKGROUND Immune checkpoint inhibitors have significantly improved survivals for an increasing range of malignancies but at the cost of several immune-related adverse events,the management of which can be challenging due to its mimicry of other autoimmune related disorders such as immunoglobulin G4(IgG4)related disease when the pancreaticobiliary system is affected.Nivolumab,an IgG4 monoclonal antibody,has been associated with cholangitis and pancreatitis,however its association with IgG4 related disease has not been reported to date.CASE SUMMARY We present a case of immune-related pancreatitis and cholangiopathy in a patient who completed treatment with nivolumab for anal squamous cell carcinoma.Patients IgG4 levels was normal on presentation.She responded to steroids but due to concerns for malignant biliary stricture,she opted for surgery,the pathology of which suggested IgG4 related disease.CONCLUSION We hypothesize this case of IgG4 related cholangitis and pancreatitis was likely triggered by nivolumab.展开更多
Surgical resection remains the only definitive treatment for colorectal liver metastasis(CRLM). However, only a minority of cases are deemed resectable at the time of diagnosis. Systemic chemotherapy along with hepati...Surgical resection remains the only definitive treatment for colorectal liver metastasis(CRLM). However, only a minority of cases are deemed resectable at the time of diagnosis. Systemic chemotherapy along with hepatic artery infusion(HAI) is an effective and safe regional chemotherapy modality for the downstaging of patients with isolated unresectable CRLM [1].展开更多
文摘BACKGROUND Immune checkpoint inhibitors have significantly improved survivals for an increasing range of malignancies but at the cost of several immune-related adverse events,the management of which can be challenging due to its mimicry of other autoimmune related disorders such as immunoglobulin G4(IgG4)related disease when the pancreaticobiliary system is affected.Nivolumab,an IgG4 monoclonal antibody,has been associated with cholangitis and pancreatitis,however its association with IgG4 related disease has not been reported to date.CASE SUMMARY We present a case of immune-related pancreatitis and cholangiopathy in a patient who completed treatment with nivolumab for anal squamous cell carcinoma.Patients IgG4 levels was normal on presentation.She responded to steroids but due to concerns for malignant biliary stricture,she opted for surgery,the pathology of which suggested IgG4 related disease.CONCLUSION We hypothesize this case of IgG4 related cholangitis and pancreatitis was likely triggered by nivolumab.
文摘Surgical resection remains the only definitive treatment for colorectal liver metastasis(CRLM). However, only a minority of cases are deemed resectable at the time of diagnosis. Systemic chemotherapy along with hepatic artery infusion(HAI) is an effective and safe regional chemotherapy modality for the downstaging of patients with isolated unresectable CRLM [1].
