Checkpoint Immunotherapy-Induced Myocarditis and Encephalitis Complicated With Complete AV Block: Not All Hope Is Lost.

ABSTRACT

Immune checkpoint inhibitors are associated with a myriad of autoimmune adverse events. We present a 70-year-old patient with renal-cell carcinoma treated with nivolumab/ipilimumab complicated with myocarditis and encephalitis in which gradual impairment of the His-Purkinje system progressed to complete atrioventricular block. Full recovery was achieved after treatment with corticosteroids and immunoglobulins. (Level of Difficulty Intermediate.).