Evans syndrome during pembrolizumab therapy for upper urinary tract cancer
Introduction Immune checkpoint inhibitors are available for the treatment of advanced urothelial carcinoma; however, serious adverse events occasionally occur. Here, we report a rare case of Evans syndrome attributed to the use of an immune checkpoint inhibitor. Case presentation A 56‐year‐old man w...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-09-01
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| Series: | IJU Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/iju5.12609 |
| _version_ | 1797694052843388928 |
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| author | Shota Kakita Tomohiro Matsuo Masaharu Ohki Ayaka Tsuchiyama Takuji Yasuda Hiromi Nakanishi Kensuke Mitsunari Kojiro Ohba Ryoichi Imamura |
| author_facet | Shota Kakita Tomohiro Matsuo Masaharu Ohki Ayaka Tsuchiyama Takuji Yasuda Hiromi Nakanishi Kensuke Mitsunari Kojiro Ohba Ryoichi Imamura |
| author_sort | Shota Kakita |
| collection | DOAJ |
| description | Introduction Immune checkpoint inhibitors are available for the treatment of advanced urothelial carcinoma; however, serious adverse events occasionally occur. Here, we report a rare case of Evans syndrome attributed to the use of an immune checkpoint inhibitor. Case presentation A 56‐year‐old man was diagnosed with left renal pelvic cancer and underwent left laparoscopic radical nephroureterectomy. Eight months postoperatively, computed tomography revealed para‐aortic lymph node metastasis. Despite receiving chemotherapy, the disease progressed, and pembrolizumab was initiated. After 26 months of pembrolizumab treatment, the patient developed fever and anemia. Hematologic examination confirmed the diagnosis of Evans syndrome. He was treated with blood transfusions and corticosteroids, and gradual symptom improvement was observed. Conclusion This report highlights the potential risk of Evans syndrome associated with immune checkpoint inhibitor treatment. Clinicians should be aware of this possibility and consider early intervention with corticosteroids. |
| first_indexed | 2024-03-12T02:51:28Z |
| format | Article |
| id | doaj.art-9f93cb5963994d3c920ce0875b4bc543 |
| institution | Directory Open Access Journal |
| issn | 2577-171X |
| language | English |
| last_indexed | 2024-03-12T02:51:28Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | IJU Case Reports |
| spelling | doaj.art-9f93cb5963994d3c920ce0875b4bc5432023-09-04T00:11:48ZengWileyIJU Case Reports2577-171X2023-09-016529830110.1002/iju5.12609Evans syndrome during pembrolizumab therapy for upper urinary tract cancerShota Kakita0Tomohiro Matsuo1Masaharu Ohki2Ayaka Tsuchiyama3Takuji Yasuda4Hiromi Nakanishi5Kensuke Mitsunari6Kojiro Ohba7Ryoichi Imamura8Department of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki JapanDepartment of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki JapanDepartment of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki JapanDepartment of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki JapanDepartment of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki JapanDepartment of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki JapanDepartment of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki JapanDepartment of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki JapanDepartment of Urology Nagasaki University Graduate School of Biomedical Sciences Nagasaki JapanIntroduction Immune checkpoint inhibitors are available for the treatment of advanced urothelial carcinoma; however, serious adverse events occasionally occur. Here, we report a rare case of Evans syndrome attributed to the use of an immune checkpoint inhibitor. Case presentation A 56‐year‐old man was diagnosed with left renal pelvic cancer and underwent left laparoscopic radical nephroureterectomy. Eight months postoperatively, computed tomography revealed para‐aortic lymph node metastasis. Despite receiving chemotherapy, the disease progressed, and pembrolizumab was initiated. After 26 months of pembrolizumab treatment, the patient developed fever and anemia. Hematologic examination confirmed the diagnosis of Evans syndrome. He was treated with blood transfusions and corticosteroids, and gradual symptom improvement was observed. Conclusion This report highlights the potential risk of Evans syndrome associated with immune checkpoint inhibitor treatment. Clinicians should be aware of this possibility and consider early intervention with corticosteroids.https://doi.org/10.1002/iju5.12609autoimmune hemolytic anemiaEvans syndromeimmune checkpoint inhibitorimmune thrombocytopenic purpuraimmune‐related adverse event |
| spellingShingle | Shota Kakita Tomohiro Matsuo Masaharu Ohki Ayaka Tsuchiyama Takuji Yasuda Hiromi Nakanishi Kensuke Mitsunari Kojiro Ohba Ryoichi Imamura Evans syndrome during pembrolizumab therapy for upper urinary tract cancer IJU Case Reports autoimmune hemolytic anemia Evans syndrome immune checkpoint inhibitor immune thrombocytopenic purpura immune‐related adverse event |
| title | Evans syndrome during pembrolizumab therapy for upper urinary tract cancer |
| title_full | Evans syndrome during pembrolizumab therapy for upper urinary tract cancer |
| title_fullStr | Evans syndrome during pembrolizumab therapy for upper urinary tract cancer |
| title_full_unstemmed | Evans syndrome during pembrolizumab therapy for upper urinary tract cancer |
| title_short | Evans syndrome during pembrolizumab therapy for upper urinary tract cancer |
| title_sort | evans syndrome during pembrolizumab therapy for upper urinary tract cancer |
| topic | autoimmune hemolytic anemia Evans syndrome immune checkpoint inhibitor immune thrombocytopenic purpura immune‐related adverse event |
| url | https://doi.org/10.1002/iju5.12609 |
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