title: Organizing pneumonia as a side effect of ipilimumab treatment of melanoma.
abstract: Ipilimumab is one of the newly developed human monoclonal antibodies used in the treatment of metastatic melanoma. Its primary mechanism of action is a specific blockade of cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), a T-cell receptor responsible for inhibition of lymphocyte activation. By blocking CTLA-4, ipilimumab enhances immune responses against tumor cells, but also exposes normal tissues to an increased risk of autoimmune phenomena as a potential side effect. In this report, we describe the case of a 58-year-old woman with metastatic melanoma who was treated with ipilimumab in the weeks prior to the onset of severe nonresolving dyspnea and cough. Extensive workup revealed organizing pneumonia as the cause of her hypoxemic respiratory failure and treatment with steroids led to a resolution of her pulmonary disease. To our knowledge, this is the first report of pulmonary toxicity caused by ipilimumab, which manifested on pathology as organizing pneumonia.
authors: New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY. Electronic address: barjaktarevic@gmail.com.
authors: Igor Z
authors: IZ
authors: Barjaktarevic
authors: New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY.
authors: Nida
authors: N
authors: Qadir
authors: Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College of Cornell Unversity, New York, NY.
authors: Anu
authors: A
authors: Suri
authors: Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College of Cornell Unversity, New York, NY.
authors: Jean T
authors: JT
authors: Santamauro
authors: Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College of Cornell Unversity, New York, NY.
authors: Diane
authors: D
authors: Stover
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D060908:CTLA-4 Antigen / Q000187:drug effects; D015897:Comorbidity; D018549:Cryptogenic Organizing Pneumonia / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology; D005260:Female; D005534:Foot Diseases / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D000074324:Ipilimumab; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
chemical_list: D000911:Antibodies, Monoclonal; D060908:CTLA-4 Antigen; D000074324:Ipilimumab