Nivolumab-induced Third Degree Atrioventricular Block in a Patient with Stage IV Squamous Cell Lung Carcinoma

In the era of immune checkpoint inhibitors, pulmonary and critical care physicians frequently encounter patients taking these medications, usually after being admitted to the intensive care unit with life-threatening complications. These complications are rare, present with nonspecific and vague sym...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2019-06, Vol.11 (6), p.e4869
Main Authors: Bukamur, Hazim S, Mezughi, Haitem, Karem, Emhemmid, Shahoub, Ibrahim, Shweihat, Yousef
Format: Article
Language:English
Subjects:
Apoptosis
Biopsy
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Case reports
Collaboration
Diabetes
Drug dosages
Dysphagia
Dyspnea
Electrocardiography
Family medical history
Heart
Hypertension
Immunoglobulins
Immunotherapy
Internal medicine
Intubation
Ischemia
Laboratories
Lung cancer
Medicine
Melanoma
Metastasis
Monoclonal antibodies
Muscle pain
Oncology
Patients
Physicians
Pulmonology
Targeted cancer therapy
Ultrasonic imaging
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Description
Summary:In the era of immune checkpoint inhibitors, pulmonary and critical care physicians frequently encounter patients taking these medications, usually after being admitted to the intensive care unit with life-threatening complications. These complications are rare, present with nonspecific and vague symptoms, which may delay the treatment and have high mortality. We report a very rare complication, with only two previously reported cases of a severe and potentially fatal side effect associated with anti-programmed cell death protein 1 (PD-1) immunotherapy with nivolumab. We provide a literature review to increase physicians' awareness about this rare side effect and suggest some recommendations derived from our experience.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.4869