A Case of Sjögren's Syndrome as an Immune-related Adverse Event of Nivolumab Treatment for Gastric Cancer

Tetsuo Higashi; Hideaki Miyamoto; Ryoji Yoshida; Yoki Furuta; Katsuya Nagaoka; Hideaki Naoe; Hisaki Naito; Hideki Nakayama; Motohiko Tanaka

doi:10.2169/internalmedicine.4701-20

This article has now been updated. Please use the final version.

A Case of Sjögren's Syndrome as an Immune-related Adverse Event of Nivolumab Treatment for Gastric Cancer

Tetsuo Higashi, Hideaki Miyamoto, Ryoji Yoshida, Yoki Furuta, Katsuya Nagaoka, Hideaki Naoe, Hisaki Naito, Hideki Nakayama, Motohiko Tanaka

Author information

Tetsuo Higashi
Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Japan
Hideaki Miyamoto
Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Japan
Ryoji Yoshida
Department of Oral and Maxillofacial Surgery, Kumamoto University, Japan
Yoki Furuta
Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Japan
Katsuya Nagaoka
Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Japan
Hideaki Naoe
Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Japan
Hisaki Naito
Department of Oral and Maxillofacial Surgery, Kumamoto University, Japan
Hideki Nakayama
Department of Oral and Maxillofacial Surgery, Kumamoto University, Japan
Motohiko Tanaka
Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Japan

Keywords: immune-related adverse event, Sjögren's syndrome, immune checkpoint inhibitors

JOURNAL OPEN ACCESS Advance online publication

Article ID: 4701-20

DOI https://doi.org/10.2169/internalmedicine.4701-20

The final version of this article is now available: Vol. 59 (2020), No. 20 pp. 2499-2504

Details

Abstract

Immune checkpoint inhibitors can affect any organ, including the salivary glands. A case of Sjögren's syndrome (SjS) induced by nivolumab for the treatment of gastric cancer is herein presented. Nivolumab treatment caused marked tumor shrinkage, but xerostomia developed after two cycles. It took 3 months after symptom onset to confirm the diagnosis of SjS. Prednisolone and pilocarpine hydrochloride did not relieve the symptoms. SjS is a relatively rare immune-related adverse event that might sometimes be overlooked. Since SjS can severely impair a patient's quality of life, oncologists should not miss any signs of salivary gland hypofunction and cooperate with specialists for SjS.

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