Abstract:
BACKGROUND:Immunotherapy represents a recent milestone in the treatment of lung cancer, particularly with the rapidly expanding development of monoclonal antibodies targeting checkpoint inhibitors in the programmed cell death-1 (PD-1) pathway, such as nivolumab and pembrolizumab. Classical auto-immune side effects of these treatments, often called immune-related adverse events (irAEs), can affect multiple organs, including the lungs in which potentially life-threatening pneumonitis may require rapid treatment with high doses of corticosteroids. Nevertheless, the occurrence of severe infections in cancer patients treated with nivolumab, outside the context of immunosuppressive therapy, is a complication that has rarely been reported in the literature. CLINICAL CASES:We report two cases of severe pulmonary infection with unusual microbes, Mycobacterium tuberculosis and Aspergillus fumigatus, in patients treated with nivolumab for non-small cell lung cancer. CONCLUSION:Ruling out pulmonary infections may require extensive investigation, as these may have an atypical presentation due to immunomodulation. Furthermore, treating the patient with corticosteroids for immune-related pneumonia could lead to a fatal outcome in this context. This report highlights the importance of excluding the presence of opportunistic infections and tuberculosis before considering immune-related pulmonary toxicity with or without a history of prior corticosteroid use. These cases also emphasize the potential value of tuberculosis screening in patients treated with PD-1 checkpoint inhibitors.
journal_name
Acta Clin Belgjournal_title
Acta clinica Belgicaauthors
Inthasot V,Bruyneel M,Muylle I,Ninane Vdoi
10.1080/17843286.2019.1629078subject
Has Abstractpub_date
2020-08-01 00:00:00pages
308-310issue
4eissn
1784-3286issn
2295-3337journal_volume
75pub_type
杂志文章abstract::We describe the case of a 39-year-old Caucasian woman who was admitted to the University Hospital of Antwerp with a clinical picture suggestive of adult Still's disease. Even though a transoesophageal echocardiography showed endocarditis of the aortic valve, blood cultures remained negative. Additional serological tes...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2008.030
更新日期:2008-05-01 00:00:00
abstract::Despite the high prevalence of malnutrition among elderly patients, nutritional problems are still not recognized as a priority forthem by health professionals. The need for nutritional assessment and intervention is particularly crucial in this age group, in whom the incidence of chronic illness is high and a myriad ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2009.017
更新日期:2009-03-01 00:00:00
abstract::In comparing four currently available immunochemical methods for immunoglobulin quantification, i.e. radial immunodiffusion (RID), rate nephelometry (RN), laser nephelometry (LN) and turbidimetry (T), highly divergent results were obtained for monoclonal immunoglobulins. Comparison with data obtained by densitometric ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/22953337.1981.11718807
更新日期:1981-01-01 00:00:00
abstract::The last two decades have witnessed that flow-assisted analysis of in vitro-activated basophils can constitute a valuable adjunct in the in vitro diagnostic approach of immediate drug hypersensitivity reactions (IDHR). This article summarises the current experience with the basophil activation test in the diagnosis of...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.2015.1122871
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES: The roundworm Ascaris lumbricoides is one of the most prevalent parasites belonging to the class of the soil-transmitted helminths. Infections are most common in developing countries with a tropical climate where sanitation and hygiene are poor. However, prevalence of ascariasis in industrialized countries ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1436956
更新日期:2018-12-01 00:00:00
abstract::As a result of the St Vincent declaration, a Belgian "task force" was installed in 1992 and consequently 16 working groups were formed. They presented their objectives in 1995. The working group "prevention and treatment of diabetic foot lesions" started the implementation of a screening program to obtain an overview ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,多中心研究
doi:10.1179/acb.2001.005
更新日期:2001-01-01 00:00:00
abstract::A tired 32-year-old woman complaining of tiredness was referred for work-up of a possible immune deficiency. She had a history of recurrent infections since birth, which usually responded to antibiotics within a few days. Her mother, a nurse, had reported that early charts had disappeared. Munchausen's by proxy was su...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.66.2.2062531
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Multicentric Castleman's disease (MCD) is a rare, non-clonal lymphoproliferative disorder characterized by constitutional symptoms, anaemia and generalised lymphadenopathy. Its incidence among the HIV-positive population seems to have increased during the past decades. AIM:The present study intends to compa...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.2143/ACB.66.1.2062510
更新日期:2011-01-01 00:00:00
abstract::The kidneys play a major role in the regulation of the salt balance and thereby regulate blood pressure. Salt sensitivity is acquired or genetically-induced and is noted in about 50% of patients with essential hypertension. This property leads to a high cardiovascular risk. In this situation, the benefit of salt restr...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2007.053
更新日期:2007-09-01 00:00:00
abstract:INTRODUCTION:Since the second World Congress on the Abdominal Compartment Syndrome (WCACS) in Noosa 2 years ago, interest and publications on intra-abdominal hypertension (IAH) and ACS have increased exponentially. This paper aimed to critically review recent publications and put this new data into the context of alrea...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:
更新日期:2007-01-01 00:00:00
abstract::In the past 2 decades, IgE-mediated NRL allergy has become a well-defined condition with recognised risk groups, established diagnostic tools, and adequate prevention strategies (1-3). Furthermore, molecular biology and biochemical techniques have significantly improved our knowledge of the proteins responsible to cau...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2002.015
更新日期:2002-03-01 00:00:00
abstract::Background and objective: The prevalence of potentially inappropriate prescribing (PIP) among nursing home (NH) residents is high. This study aimed to investigate the acceptance and implementation of pharmacist recommendations based on a screening tool for PIP, the Ghent Older People's Prescriptions community Pharmacy...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2019.1634323
更新日期:2020-12-01 00:00:00
abstract::Pancreatic nodules are frequently found incidentally and often pose a diagnostic and therapeutic challenge when surgery is considered. We present the case of a 66-year-old cirrhotic patient with a pancreatic nodule with signal intensity and contrast enhancement pattern suggestive for a non-functional neuroendocrine le...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2020.1762351
更新日期:2020-05-12 00:00:00
abstract::We report a skin Mycobacterium marinum infection presenting as wide ulcerative lesions of the arm (4 cm for the widest) in a hypoxic COPD patient who takes 4 mg methylprednisolone daily and higher doses during exacerbations. Diagnostic delay as well as glucocorticoid use could be responsible for the extension of the l...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.66.4.2062576
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of one year continuous positive airway pressure (CPAP) treatment on metabolic syndrome (MS) prevalence and components in patients diagnosed with both obstructive sleep apnea syndrome (OSAS) and metabolic syndrome. METHODS:This was a single center, observational prospective cohort st...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2009.051
更新日期:2009-07-01 00:00:00
abstract::Thorax scan was performed for elucidation of a pulmonary problem in a Nigerian immigrant. The aspect of the vertebrae suggested sickle cell disease, of course without specification of the genotype. Routine hematological tests seemed compatible with an HbSC disease, showing typical laboratory features, namely a signifi...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2005.057
更新日期:2005-11-01 00:00:00
abstract::Background and aim: Nontraumatic intracerebral hemorrhage (ICH) remains a devastating disease for high in-hospital and long-term mortality and residual neurological disability. The aim of our study was to analyze the prognostic factors in patients managed for ICH in the real-life clinical practice.Materials and Method...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2020.1750151
更新日期:2020-04-12 00:00:00
abstract::Non-closure of abdominal fascia and the resultant open abdomen after laparotomy has become a major advance in the management of critically ill or injured patients. The benefits of open abdomen are many and include the prevention of intra-abdominal hypertension and the consequent abdominal compartment syndrome. Appropr...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2007.62.s1.027
更新日期:2007-01-01 00:00:00
abstract::Sepsis is characterized by disturbances in liver perfusion and alterations in intrahepatic cellular functions and interactions. This provokes structural and functional liver damage as well as hepatocellular activation that is believed to perpetuate the immuno-inflammatory response. Changes in hepatic perfusion during ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract::We retrospectively studied 29 cases of S.pyogenes bacteremia, treated from September 1985 through September 1993, in order to define the clinical pattern, predisposing factors and the outcome of S.pyogenes bacteremia in our region. The number of infections, the clinical picture and mortality rate of S.pyogenes bactere...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1995.11718427
更新日期:1995-01-01 00:00:00
abstract::The in vitro activity of cefepime has been compared with that of cefotaxime, ceftazidime, aztreonam, and piperacillin against 1826 Enterobacteriaceae including 537 inducible Enterobacteriaceae (Enterobacter spp., Serratia spp., Citrobacter spp,. Morganella morganii) and 572 non-fermenters, including 401 Pseudomonas ae...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,多中心研究
doi:
更新日期:1996-01-01 00:00:00
abstract::Intradural spinal arachnoid cysts are a relatively uncommon lesion that may be either intra, or extradural, and intradural spinal arachnoid cysts are even less common. Arachnoid cysts are cerebrospinal fluid collections in the spine that can present with neurological symptoms. The objective of this paper is to describ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2016.1139288
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVES:Although emergency department (ED) return visits are a significant problem universally, it has not been previously studied in our ED. The aim of this study was to determine the extent of the problem in our ED, to identify the relevant clinical predictor variables and to detect diagnostic errors. METHODS:A r...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2009.069
更新日期:2009-09-01 00:00:00
abstract::Epidemiological studies have shown that chronic kidney disease (CKD) is a major health problem especially in an older population. Given the growing segment of the elderly population and the important implication of renal disease on health care, this review discusses the structural and functional changes of the ageing ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2008.002
更新日期:2008-01-01 00:00:00
abstract::Abnormal endothelial function plays a pivota role in the pathogenesis of diabetic complications. Due to lack of autoregulation of glucose transport in the presence of high extracellular glucose concentrations, intracellular hyperglycaemia induces a series of metabolic changes that ultimately lead to the genesis of bot...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2007.017
更新日期:2007-03-01 00:00:00
abstract::We report a case of aneurysm of the abdominal aorta with spontaneous rupture in a 64-year-old man with emphysema and chronic alcoholism. Campylobacter fetus subspecies fetus was repeatedly recovered from the blood and from specimens of the excised aneurysm. The patient died in spite of early diagnosis, intravenous ery...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.1989.11717999
更新日期:1989-01-01 00:00:00
abstract::The diagnosis of infective endocarditis remains difficult. The complication rate is very high. Serious complications may occur and the overall mortality is still 20-25%. The sooner the treatment is started, the better the final result. Antibiotic therapy is essential but cardiac surgery is frequently necessary. Early ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2008.085
更新日期:2008-11-01 00:00:00
abstract::The authors report the case of a 67-year-old woman, with mitral valve prolapse, for more than 20 years. She recently complained of attacks of syncope and clinical ventricular tachycardia; ventricular fibrillation was induced during programmed stimulation. The patient seemed to be at high risk for sudden cardiac death,...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::Although giant cell arteritis, also called temporal arteritis, is the most common primary vasculitis in the elderly, an association with AA amyloidosis has rarely been reported. AA amyloidosis is a disorder that results from the extracellular deposition of proteolytic cleavage products of serum amyloid A, which occurs...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2020.1763671
更新日期:2020-05-12 00:00:00
abstract::Coronary artery disease is frequently associated with disturbed blood lipids and with a deficient blood fibrinolytic capacity. In order to investigate a possible link between hypercholesterolemia and hypofibrinolysis, we have investigated the effect of simvastatin, a HMG-CoA reductase inhibitor, on blood lipids and fi...
journal_title:Acta clinica Belgica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/17843286.1992.11718214
更新日期:1992-01-01 00:00:00