• Anna J Lomax and Catriona McNeil.
• Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
• Emerg Med Australas. 2017 Apr 1; 29 (2): 245-251.

AbstractWhen a patient receiving anti-cancer treatment presents acutely unwell, an understanding of associated side effects of their therapy is critical. This review will discuss the approach to patients receiving anti-cancer treatment with immunotherapy presenting with autoimmune toxicities in the emergency setting. These toxicities are commonly referred to as immune-related adverse events (irAE). IrAE might consist of, but are not limited to, dermatologic, gastrointestinal (diarrhoea, colitis), hepatic, endocrine (thyroid dysfunction, hypophysitis, adrenal crisis), renal, ocular and pulmonary toxicity. General principles of managing these irAE in the acute setting will be outlined. Steroid therapy is a critical component of the treatment algorithm, being administered at high doses and for prolonged periods to switch off immune over-activation. Prompt intervention might prevent multi-organ failure and fatality, and allow patients to remain on effective anti-cancer therapy.© 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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