Profound postinduction hypotension precipitated by immune checkpoint inhibitors: a case report.
J Med Case Rep
; 18(1): 146, 2024 Mar 09.
Article
em En
| MEDLINE
| ID: mdl-38459576
ABSTRACT
BACKGROUND:
With the increasing use of immune checkpoint inhibitors (ICIs) in cancer therapy, perioperative healthcare professionals need to be vigilant about potential immune-related adverse events (irAEs). We report a case of severe postinduction hypotension in a patient undergoing laparotomy due to suspected intraabdominal bleeding from gastric cancer and Krukenberg tumors, caused by unrecognized hypothyroidism precipitated by ICIs. CASE PRESENTATION A 65-year-old Chinese female with a history of gastric adenocarcinoma and Krukenberg tumors, previously treated with nivolumab, presented to the emergency room with abdominal pain and hypotension. Despite ruling out other causes, including hypovolemia and anaphylaxis, her hypotension persisted. The patient was found to have severe hypothyroidism, likely an irAE from the use of nivolumab. Thyroxine replacement therapy resolved the hypotension, and the patient recovered uneventfully after surgery.CONCLUSIONS:
This case underscores the importance of considering irAEs, such as hypothyroidism, in patients treated with ICIs. Perioperative healthcare providers must remain vigilant for potential complications and promptly recognize and manage irAEs to optimize patient outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Tipos_de_cancer
/
Estomago
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Gástricas
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Antineoplásicos Imunológicos
/
Hipotireoidismo
Limite:
Aged
/
Female
/
Humans
Idioma:
En
Revista:
J Med Case Rep
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
China