抄録
Although drug-induced interstitial pneumonia is a well-known adverse effect of nivolumab, pleuritis is rare. A case of nivolumab-related pleuritis showing decreased pleural complement titres is presented. A 74-year-old woman with lung adenocarcinoma (T4N2M1a) was admitted to our hospital because of dry cough and dyspnoea. Three months prior to admission, she started receiving nivolumab as second-line chemotherapy. After finishing 6-courses of chemotherapy, she developed dyspnoea on exertion. Thoracic computed tomography showed a pleural effusion. Although pleural cytology was performed three times, the results showed no evidence of malignancy. Increased pleural LDH and total protein, with a decreased 50% haemolytic unit of complement (CH50) titre, were found. Because nivolumab-associated pleuritis was suspected, prednisolone was started, and chemotherapy was discontinued. Her dry cough and dyspnoea decreased gradually. When a pleural effusion is seen during treatment with nivolumab, measuring the CH50 titre might be useful to make the diagnosis of an immune-related adverse event.
