ArticleOxford medical case reports2026
Immune checkpoint inhibitor-associated hepatotoxicity and ileitis: a diagnostic challenge in a patient on long-term nivolumab therapy.
Article in Oxford medical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Immune checkpoint inhibitors (ICIs) improve cancer outcomes but may cause immune-related adverse events (irAEs). Nivolumab, an anti-PD-1 agent, is associated with hepatotoxicity and gastrointestinal toxicity. Case Presentation: A 33-year-old American male with anaplastic large cell lymphoma of the lung, maintained on nivolumab monotherapy for five years, presented in late 2024 with fever (102.8°F), tachycardia (130 bpm), fatigue, nausea, vomiting, and abdominal discomfort. Laboratory tests revealed mild transaminitis; infectious workup was negative. CT imaging showed mild hepatic steatosis, distal ileitis, and mesenteric lymphadenopathy. Suspected nivolumab toxicity led to permanent discontinuation of therapy and initiation of high-dose corticosteroids, resulting in rapid improvement. He was discharged on day four with a steroid taper and TMP-SMX prophylaxis but was lost to follow-up. Conclusion: This case emphasizes the potential for delayed nivolumab-induced hepatotoxicity and ileitis, underscoring the importance of early recognition and prompt management of late-onset irAEs.
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