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http://dx.doi.org/10.1684/ejd.2021.4181DOI Listing

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From cortisol-producing adrenal adenoma to atrial myxoma, through nivolumab-induced hypophysitis: a complicated case report of Carney Complex.

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December 2024

Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.

Article Synopsis
  • Carney complex (CNC) is a rare disease caused by changes in the PRKAR1A gene, leading to skin changes and various tumors.
  • A 41-year-old woman with a complicated medical history faced challenges when doctors tried to find out what was wrong with her, which included multiple tumors and strokes.
  • Genetic testing finally confirmed she had CNC, showing how important teamwork among doctors is for diagnosing and treating rare health issues.
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BACKGROUND CRS (cytokine release syndrome) is a massive activation of the inflammatory system characterized by a supra-physiological rate of inflammatory cytokines. The interleukin 6 cytokine plays a central role in CRS. The main clinical sign of CRS is fever, but CRS can lead to multiple organ failure in severe cases.

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Immune checkpoint inhibitors, including nivolumab, can result in immune-related adverse events (irAEs) that may affect multiple organ systems. Among irAEs, both gastritis and cholangitis are uncommon. We present the case of a 65-year-old man who received nivolumab for lung adenocarcinoma presented with epigastric pain.

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Clinical management of patients with local control failure following stereotactic radiosurgery (SRS) for brain metastasis (BM) can be frequently challenging. Re-irradiation with multi-fraction (fr) SRS by using a biological effective dose of ≥80 Gy, based on the linear-quadratic formula with an alpha/beta ratio of 10 (BED), can be an efficacious option for such a scenario with the BED of <80 Gy. However, its long-term safety beyond one year remains unclear.

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Article Synopsis
  • Immune checkpoint inhibitors can rejuvenate helper T-cells, which may lead to autoimmune disease-like conditions, including drug-induced arthritis.
  • The specific diagnostic process for this type of arthritis remains unclear, and this study evaluates the effectiveness of 99m Tc-MDP bone scintigraphy in diagnosing nivolumab-induced inflammatory arthritis.
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