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Journal of Medical Case Reports

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Open Access 09-03-2024 | Adverse Effects of Cancer Therapy | Case report

Profound postinduction hypotension precipitated by immune checkpoint inhibitors: a case report

Authors: Lu Che, Afang Zhu, Wen Chen, Chunhua Yu

Published in: Journal of Medical Case Reports | Issue 1/2024

Abstract

Background

With the increasing use of immune checkpoint inhibitors (ICIs) in cancer therapy, perioperative healthcare professionals need to be vigilant about potential immune-related adverse events (irAEs). We report a case of severe postinduction hypotension in a patient undergoing laparotomy due to suspected intraabdominal bleeding from gastric cancer and Krukenberg tumors, caused by unrecognized hypothyroidism precipitated by ICIs.

Case presentation

A 65-year-old Chinese female with a history of gastric adenocarcinoma and Krukenberg tumors, previously treated with nivolumab, presented to the emergency room with abdominal pain and hypotension. Despite ruling out other causes, including hypovolemia and anaphylaxis, her hypotension persisted. The patient was found to have severe hypothyroidism, likely an irAE from the use of nivolumab. Thyroxine replacement therapy resolved the hypotension, and the patient recovered uneventfully after surgery.

Conclusions

This case underscores the importance of considering irAEs, such as hypothyroidism, in patients treated with ICIs. Perioperative healthcare providers must remain vigilant for potential complications and promptly recognize and manage irAEs to optimize patient outcomes.

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Title: Profound postinduction hypotension precipitated by immune checkpoint inhibitors: a case report
Authors: Lu Che
Afang Zhu
Wen Chen
Chunhua Yu
Publication date: 09-03-2024
Publisher: BioMed Central
Keywords: Adverse Effects of Cancer Therapy
Hypotension
Hypothyroidism
Checkpoint Inhibitors
Krukenberg Tumor
Krukenberg Tumor
Gastric Cancer
Gastric Cancer
Published in: Journal of Medical Case Reports / Issue 1/2024
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-024-04375-9

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Abstract

Background

Case presentation

Conclusions

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