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Ipilimumab induced digital vasculitis
Immune check point inhibitors (ICIs) have emerged as a new therapeutic paradigm for a variety of malignancies including metastatic melanoma. As the use of ICIs expand, immune-mediated adverse events are becoming a common occurrence. We describe the first reported patient with small vessel vasculitis...
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| Published in: | Journal for immunotherapy of cancer 2018-02, Vol.6 (1), p.12-5, Article 12 |
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| container_end_page | 5 |
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| container_title | Journal for immunotherapy of cancer |
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| creator | Padda, Amrita Schiopu, Elena Sovich, Justin Ma, Vincent Alva, Ajjai Fecher, Leslie |
| description | Immune check point inhibitors (ICIs) have emerged as a new therapeutic paradigm for a variety of malignancies including metastatic melanoma. As the use of ICIs expand, immune-mediated adverse events are becoming a common occurrence.
We describe the first reported patient with small vessel vasculitis, manifested by digital ischemia, following treatment with high dose Ipilimumab for resected stage IIIB/C melanoma. This patient received high dose steroids, five-day intravenous (IV) Epoprostenol protocol, botulinum toxin injections, and Rituximab 375 mg/m
weekly for four cycles. With this treatment regimen, the digital ischemia did not progress proximally, but she did require multiple distal digit amputations about six months after the onset of her symptoms.
Prompt identification and management of immune related adverse events (IRAEs) are critical to optimal patient management. This patient's vasculitis did not reverse, but was likely halted and stabilized with multiple immunosuppressive medications. |
| doi_str_mv | 10.1186/s40425-018-0321-2 |
| format | article |
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We describe the first reported patient with small vessel vasculitis, manifested by digital ischemia, following treatment with high dose Ipilimumab for resected stage IIIB/C melanoma. This patient received high dose steroids, five-day intravenous (IV) Epoprostenol protocol, botulinum toxin injections, and Rituximab 375 mg/m
weekly for four cycles. With this treatment regimen, the digital ischemia did not progress proximally, but she did require multiple distal digit amputations about six months after the onset of her symptoms.
Prompt identification and management of immune related adverse events (IRAEs) are critical to optimal patient management. This patient's vasculitis did not reverse, but was likely halted and stabilized with multiple immunosuppressive medications.</description><identifier>ISSN: 2051-1426</identifier><identifier>EISSN: 2051-1426</identifier><identifier>DOI: 10.1186/s40425-018-0321-2</identifier><identifier>PMID: 29433584</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Antibodies ; Antineoplastic Agents, Immunological - adverse effects ; Cancer ; Cancer metastasis ; Care and treatment ; Case Report ; Complications and side effects ; Disease prevention ; FDA approval ; Female ; Hepatitis ; Humans ; Immune related adverse events (IRAEs) ; Immunosuppressive agents ; Immunotherapy ; Inflammatory bowel disease ; Ipilimumab ; Ipilimumab - adverse effects ; Ischemia ; Lymphatic system ; Melanoma ; Melanoma - drug therapy ; Metastasis ; Middle Aged ; Monoclonal antibodies ; Neutrophils ; Pain ; Patients ; Rituximab ; Skin Neoplasms - drug therapy ; Steroids ; Targeted cancer therapy ; Vasculitis ; Vasculitis - chemically induced</subject><ispartof>Journal for immunotherapy of cancer, 2018-02, Vol.6 (1), p.12-5, Article 12</ispartof><rights>COPYRIGHT 2018 BioMed Central Ltd.</rights><rights>2018 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s). 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c591t-d883b6c4d7d9d1d637c7731af70e748ed9deff3dc61161eadc2e8617888fa4233</citedby><cites>FETCH-LOGICAL-c591t-d883b6c4d7d9d1d637c7731af70e748ed9deff3dc61161eadc2e8617888fa4233</cites><orcidid>0000-0001-8186-1096</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2638115244/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2638115244?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,44569,53770,53772,74873</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29433584$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Padda, Amrita</creatorcontrib><creatorcontrib>Schiopu, Elena</creatorcontrib><creatorcontrib>Sovich, Justin</creatorcontrib><creatorcontrib>Ma, Vincent</creatorcontrib><creatorcontrib>Alva, Ajjai</creatorcontrib><creatorcontrib>Fecher, Leslie</creatorcontrib><title>Ipilimumab induced digital vasculitis</title><title>Journal for immunotherapy of cancer</title><addtitle>J Immunother Cancer</addtitle><description>Immune check point inhibitors (ICIs) have emerged as a new therapeutic paradigm for a variety of malignancies including metastatic melanoma. As the use of ICIs expand, immune-mediated adverse events are becoming a common occurrence.
We describe the first reported patient with small vessel vasculitis, manifested by digital ischemia, following treatment with high dose Ipilimumab for resected stage IIIB/C melanoma. This patient received high dose steroids, five-day intravenous (IV) Epoprostenol protocol, botulinum toxin injections, and Rituximab 375 mg/m
weekly for four cycles. With this treatment regimen, the digital ischemia did not progress proximally, but she did require multiple distal digit amputations about six months after the onset of her symptoms.
Prompt identification and management of immune related adverse events (IRAEs) are critical to optimal patient management. This patient's vasculitis did not reverse, but was likely halted and stabilized with multiple immunosuppressive medications.</description><subject>Antibodies</subject><subject>Antineoplastic Agents, Immunological - adverse effects</subject><subject>Cancer</subject><subject>Cancer metastasis</subject><subject>Care and treatment</subject><subject>Case Report</subject><subject>Complications and side effects</subject><subject>Disease prevention</subject><subject>FDA approval</subject><subject>Female</subject><subject>Hepatitis</subject><subject>Humans</subject><subject>Immune related adverse events (IRAEs)</subject><subject>Immunosuppressive agents</subject><subject>Immunotherapy</subject><subject>Inflammatory bowel disease</subject><subject>Ipilimumab</subject><subject>Ipilimumab - adverse effects</subject><subject>Ischemia</subject><subject>Lymphatic system</subject><subject>Melanoma</subject><subject>Melanoma - drug therapy</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Neutrophils</subject><subject>Pain</subject><subject>Patients</subject><subject>Rituximab</subject><subject>Skin Neoplasms - drug therapy</subject><subject>Steroids</subject><subject>Targeted cancer therapy</subject><subject>Vasculitis</subject><subject>Vasculitis - chemically induced</subject><issn>2051-1426</issn><issn>2051-1426</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptklFrFDEUhYMottT-AF9kQfRtam6SSTIvQilWFwq-6HPIJDe7WWYmazJT8N-bdmvdBclDws05H_deDiFvgV4BaPmpCCpY21DQDeUMGvaCnDPaQgOCyZdH7zNyWcqOUgqUc631a3LGOsF5q8U5-bDexyGOy2j7VZz84tCvfNzE2Q6re1vcMsQ5ljfkVbBDwcun-4L8vP3y4-Zbc_f96_rm-q5xbQdz47XmvXTCK9958JIrpxQHGxRFJTTWKobAvZMAEtB6x1BLULWpYAXj_IKsD1yf7M7scxxt_m2SjeaxkPLG2DxHN6ABhKC4Q0TFRBtC75nrqFey9wiaQWV9PrD2Sz-idzjN2Q4n0NOfKW7NJt2bVtNO864C3j8Bcvq1YJnNLi15qvMbJrkGaJkQ_1QbW7uKU0gV5sZYnLluhaSaMSmr6uo_qno8jtGlCUOs9RPDxyPDFu0wb0saljmmqZwK4SB0OZWSMTxPCNQ8BMUcgmJqUMxDUAyrnnfHq3l2_I0F_wO6erYn</recordid><startdate>20180212</startdate><enddate>20180212</enddate><creator>Padda, Amrita</creator><creator>Schiopu, Elena</creator><creator>Sovich, Justin</creator><creator>Ma, Vincent</creator><creator>Alva, Ajjai</creator><creator>Fecher, Leslie</creator><general>BioMed Central Ltd</general><general>BMJ Publishing Group LTD</general><general>BioMed Central</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-8186-1096</orcidid></search><sort><creationdate>20180212</creationdate><title>Ipilimumab induced digital vasculitis</title><author>Padda, Amrita ; 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As the use of ICIs expand, immune-mediated adverse events are becoming a common occurrence.
We describe the first reported patient with small vessel vasculitis, manifested by digital ischemia, following treatment with high dose Ipilimumab for resected stage IIIB/C melanoma. This patient received high dose steroids, five-day intravenous (IV) Epoprostenol protocol, botulinum toxin injections, and Rituximab 375 mg/m
weekly for four cycles. With this treatment regimen, the digital ischemia did not progress proximally, but she did require multiple distal digit amputations about six months after the onset of her symptoms.
Prompt identification and management of immune related adverse events (IRAEs) are critical to optimal patient management. This patient's vasculitis did not reverse, but was likely halted and stabilized with multiple immunosuppressive medications.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>29433584</pmid><doi>10.1186/s40425-018-0321-2</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-8186-1096</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal for immunotherapy of cancer, 2018-02, Vol.6 (1), p.12-5, Article 12 |
| issn | 2051-1426 2051-1426 |
| language | eng |
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| source | BMJ Open Access Journals; Publicly Available Content (ProQuest); PubMed Central |
| subjects | Antibodies Antineoplastic Agents, Immunological - adverse effects Cancer Cancer metastasis Care and treatment Case Report Complications and side effects Disease prevention FDA approval Female Hepatitis Humans Immune related adverse events (IRAEs) Immunosuppressive agents Immunotherapy Inflammatory bowel disease Ipilimumab Ipilimumab - adverse effects Ischemia Lymphatic system Melanoma Melanoma - drug therapy Metastasis Middle Aged Monoclonal antibodies Neutrophils Pain Patients Rituximab Skin Neoplasms - drug therapy Steroids Targeted cancer therapy Vasculitis Vasculitis - chemically induced |
| title | Ipilimumab induced digital vasculitis |
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