• Internal medicine · Oct 2024

    Case Reports

    Cytokine Release Syndrome with Relative Adrenal Insufficiency Induced by Ipilimumab and Nivolumab Combination Therapy for Clear Cell Renal Cell Carcinoma.

    • Kohei Yamamoto, Shinsuke Shiotsu, Misaki Sasakura, Shunya Tanaka, Shiho Goda, Taisuke Tsuji, Tatsuya Yuba, Chieko Takumi, and Noriya Hiraoka.
    • Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Japan.
    • Intern. Med. 2024 Oct 1; 63 (19): 270327072703-2707.

    AbstractCombination therapy with ipilimumab and nivolumab is indicated for many types of cancers; however, several patients experience immune-related adverse events (irAEs). We herein report a case of cytokine release syndrome (CRS) in a 63-year-old woman with stage IV left clear cell renal cell carcinoma. Our patient developed CRS while taking prednisolone, 43 days after the start of ipilimumab and nivolumab administration. The patient was treated with steroid pulse therapy, which improved the symptoms of shock and respiratory failure. Increased vascular permeability and relative adrenal insufficiency are considered to be the main pathogeneses. The early administration of high-dose steroids is crucial as a replacement for corticosteroids.

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