title: Suspected autoimmune myocarditis and cardiac conduction abnormalities with nivolumab therapy for non-small cell lung cancer.
abstract: Checkpoint inhibitors such as nivolumab represent a novel class of agents that are being increasingly used in the treatment of various cancers. Their toxicities represent unique challenges to the oncologists prescribing them, patients' primary care physicians and other specialists who may encounter these patients during consultations. It is important for physicians to remain vigilant and include autoimmune toxicities in the list of potential differential diagnoses in patients receiving novel cancer therapeutics who present with unusual toxicities. We report the unusual case of a 68-year-old woman with advanced lung cancer on the novel chemotherapeutic Nivolumab whom we suspect developed autoimmune myocarditis with significant cardiac conduction disease as an unintended, and as of yet unrecognised, side effect from this medication.
authors.affiliation: Department of Internal Medicine, University of Florida, Gainesville, Florida, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Gibson
authors.affiliation: Department of Internal Medicine, University of Florida, Gainesville, Florida, USA.
authors.forename: Jess
authors.initials: J
authors.lastname: Delaune
authors.affiliation: Department of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Szady
authors.affiliation: Department of Oncology, University of Florida, Gainesville, Florida, USA.
authors.forename: Merry
authors.initials: M
authors.lastname: Markham
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000276:immunology; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000276:immunology; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000276:immunology; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000276:immunology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000187:drug effects; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D009205:Myocarditis / Q000139:chemically induced* / Q000276:immunology; D000077594:Nivolumab
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000077594:Nivolumab