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Case Report

Severe Immune Thrombocytopenia Induced by a Single Dose of Nivolumab in a Patient with Advanced Non-Small Cell Lung Cancer

Department of Medicine, Stony Brook University Hospital, NY, USA
*
Author to whom correspondence should be addressed.
Clin. Pract. 2020, 10(2), 1249; https://doi.org/10.4081/cp.2020.1249
Submission received: 26 February 2020 / Revised: 14 June 2020 / Accepted: 15 June 2020 / Published: 17 June 2020

Abstract

Nivolumab-induced immune thrombocytopenia (ITP) is a rare process with few reported cases. We present a 67-year-old man with advanced non-small cell lung cancer who was hospitalized with severe thrombocytopenia. Physical exam was notable for petechiae across his chest and extremities as well as bullae in his oral cavity. The patient initially received high-dose glucocorticoids and intravenous immuno - globulin, but did not respond to treatment. He was then started on weekly rituximab and after three doses, there was complete resolution of his thrombocytopenia. Altogether, his presentation was an extreme case and rare side effect of immune checkpoint therapy, known as nivolumab-induced ITP. Diagnosis of nivolumab-induced ITP is challenging given the lack of specific testing and a wide differential diagnosis. There are few cases reporting severe ITP following nivolumab treatment. We highlight the importance of recognizing and treating this rare complication of immunotherapy.
Keywords: nivolumab; immune checkpoint inhibitor; non-small cell lung cancer; immune-related thrombocytopenia nivolumab; immune checkpoint inhibitor; non-small cell lung cancer; immune-related thrombocytopenia

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MDPI and ACS Style

Khorasanchi, A.; Keresztes, R. Severe Immune Thrombocytopenia Induced by a Single Dose of Nivolumab in a Patient with Advanced Non-Small Cell Lung Cancer. Clin. Pract. 2020, 10, 1249. https://doi.org/10.4081/cp.2020.1249

AMA Style

Khorasanchi A, Keresztes R. Severe Immune Thrombocytopenia Induced by a Single Dose of Nivolumab in a Patient with Advanced Non-Small Cell Lung Cancer. Clinics and Practice. 2020; 10(2):1249. https://doi.org/10.4081/cp.2020.1249

Chicago/Turabian Style

Khorasanchi, Adam, and Roger Keresztes. 2020. "Severe Immune Thrombocytopenia Induced by a Single Dose of Nivolumab in a Patient with Advanced Non-Small Cell Lung Cancer" Clinics and Practice 10, no. 2: 1249. https://doi.org/10.4081/cp.2020.1249

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