title: Severe Acute Orthopnea: Ipilimumab-Induced Bilateral Phrenic Nerve Neuropathy.
abstract: Ipilimumab is a monoclonal antibody used in the treatment of unresectable or metastatic melanoma. Several immune-related adverse events including potential fatal events have been reported following its use. We report a case of a 66-year-old man who presented with severe acute exertional dyspnea and orthopnea following administration of ipilimumab for metastatic melanoma. Although various peripheral neuropathy syndromes associated with ipilimumab have been reported, bilateral phrenic nerve paralysis has not been previously reported. This case also highlights the clinical features of bilateral phrenic nerve neuropathy. Pulmonologists have to be aware of these unusual immune-related respiratory adverse events in patients being treated with monoclonal antibodies.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic Rochester, 200 First St. SW, Rochester, MN, 55905, USA.
authors.forename: Praveen
authors.initials: P
authors.lastname: Jinnur
authors.forename: Kaiser G
authors.initials: KG
authors.lastname: Lim
mesh_terms: D000208:Acute Disease; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D004417:Dyspnea / Q000139:chemically induced*; D006801:Humans; D000074324:Ipilimumab; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D010791:Phrenic Nerve; D016683:Supine Position / Q000502:physiology
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000074324:Ipilimumab