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- Title
A case report of severe pulmonary arterial hypertension after nivolumab, an IgG4 anti-PD1 monoclonal antibody.
- Authors
Lei, Yuanli; Wang, Weijia
- Abstract
Background Pulmonary hypertension has been increasingly reported in association with immunotherapy, but generally lacking invasive haemodynamic confirmation in literature. We present the first case of pulmonary arterial hypertension following nivolumab confirmed with invasive haemodynamic measurements. Case summary A 65-year-old male with gastro-oesophageal adenocarcinoma developed progressive dyspnoea with exertion, decreasing exercise tolerance after receiving nivolumab for seven months. He was admitted with acute hypoxaemic respiratory failure after syncope at home. The patient was diagnosed with pulmonary arterial hypertension (PAH) with pre-capillary aetiology with right heart catheterization (RHC): mean pulmonary artery pressure 49 mmHg, pulmonary capillary wedge pressure 7 mmHg, and cardiac index 1.3 L/min/m2. Based on serial echocardiograms, the development of PAH appeared to be associated with nivolumab. The patient died of cardiac arrest 3 days after admission. Discussion Progressive unexplained dyspnoea after receiving programmed cell death protein 1 monoclonal antibody should prompt clinicians to consider PAH and RHC.
- Subjects
PULMONARY arterial hypertension; NIVOLUMAB; MONOCLONAL antibodies; EXERCISE tolerance; CARDIAC catheterization; GASTROPARESIS; PULMONARY hypertension
- Publication
European Heart Journal Case Reports, 2024, Vol 8, Issue 5, p1
- ISSN
2514-2119
- Publication type
Article
- DOI
10.1093/ehjcr/ytae222