2022 Volume 55 Issue 8 Pages 483-490
Immune checkpoint inhibitors (ICIs) may cause immune-related adverse events (irAEs) mediated by immune mechanisms. Here, we report a case of unresectable advanced esophageal cancer in which severe irAEs developed due to an ICI. The patient was a 79-year-old male who was diagnosed with unresectable advanced esophageal cancer and underwent immunotherapy as third-line treatment. After four courses of immunotherapy, the patient developed ICI-related tuberculosis (TB). Immunotherapy was discontinued and TB treatment was given priority. Six months later, nivolumab was resumed in parallel with TB treatment, but three weeks after resumption of immunotherapy, immune thrombocytopenic purpura developed, in addition to immune-related liver and renal damage. Steroid treatment for irAEs led to normalization of platelet counts and improvement of liver and renal damage after two weeks. The patient was discharged from hospital after one month of this treatment. After discharge, there was no evidence of tumor progression for three months after the last administration of nivolumab.
