Nivolumab-induced Thrombotic Thrombocytopenic Purpura in Patients with Gastric Tube Cancer

Intern Med. 2024 Oct 1;63(19):2667-2671. doi: 10.2169/internalmedicine.2931-23. Epub 2024 Mar 4.

Abstract

Recently, immune checkpoint inhibitors (ICIs) have been used to treat several cancer types. ICIs have been reported to cause a wide variety of immune-related adverse events, including endocrine, neurologic, gastrointestinal, and cutaneous disorders. Thrombotic thrombocytopenic purpura (TTP) is an autoimmune hematologic disorder characterized by the presence of autoantibodies against a disintegrin and metalloprotease with thrombospondin-1, member 13. Several previous cases of TTP were thought to have been caused by ICI treatment. We herein report a rare case of TTP that developed after long-term treatment with an ICI (nivolumab) for gastric tube cancer.

Keywords: gastric tube cancer; hematological adverse events; immune checkpoint inhibitor; immunotherapy-related adverse events; nivolumab; thrombotic thrombocytopenic purpura.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents, Immunological / adverse effects
  • Female
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Male
  • Middle Aged
  • Nivolumab* / adverse effects
  • Purpura, Thrombotic Thrombocytopenic* / chemically induced
  • Purpura, Thrombotic Thrombocytopenic* / diagnosis
  • Stomach Neoplasms* / drug therapy

Substances

  • Nivolumab
  • Immune Checkpoint Inhibitors
  • Antineoplastic Agents, Immunological