PMID- 32580711
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 20
IP  - 1
DP  - 2020 Jun 24
TI  - Vogt-Koyanagi-Harada disease-like uveitis following nivolumab administration 
      treated with steroid pulse therapy: a case report.
PG  - 252
LID - 10.1186/s12886-020-01519-5 [doi]
LID - 252
AB  - BACKGROUND: Immune checkpoint inhibitors can cause various adverse effects. 
      Recently it has been shown that Vogt-Koyanagi-Harada (VKH) disease-like uveitis 
      can occur in patients treated with nivolumab. CASE PRESENTATION: A 69-year-old 
      man developed bilateral panuveitis after nivolumab treatment for recurrent 
      hypopharyngeal cancer. Slit lamp examination revealed bilateral granulomatous 
      keratic precipitates, anterior chamber cells and partial synechiae. Fundus 
      examination revealed bilateral optic disc edema and diffuse serous retinal 
      detachment. His human leukocyte antigen (HLA) typing showed HLA-DRB1*04:05 
      allele. A lumbar puncture did not demonstrate pleocytosis. Bilateral sub-tenon 
      injections of triamcinolone acetonide were initiated. As his panuveitis did not 
      regress completely, steroid pulse therapy was administered. That therapy led to 
      the resolution of his serous retinal detachment and to rapid improvement in his 
      vision. Following this, we treated him with 50 mg/day of prednisolone for 1 week 
      and then reduced it by 5 mg every week. No bilateral uveitis relapse had occurred 
      by his 3-month follow-up; however, he subsequently died because of his cancer. 
      CONCLUSION: To our knowledge, this is the first report of a patient with NVKH who 
      underwent a lumbar puncture. Unlike VKH, our case did not show meningismus or 
      pleocytosis. NVKH may, therefore, have a different etiology from VKH. In cases of 
      NVKH with posterior uveitis, steroid pulse therapy may be considered as a 
      treatment option, as it is in VKH.
FAU - Kikuchi, Ryo
AU  - Kikuchi R
AD  - Department of Ophthalmology, Kameda Medical Center, Kamogawa, Japan.
FAU - Kawagoe, Tatsukata
AU  - Kawagoe T
AD  - Department of Ophthalmology, Kameda Medical Center, Kamogawa, Japan. 
      kawagoe@yokohama-cu.ac.jp.
AD  - Department of Ophthalmology and Visual Science, Yokohama City University School 
      of Medicine, Yokohama, Japan. kawagoe@yokohama-cu.ac.jp.
FAU - Hotta, Kazuki
AU  - Hotta K
AD  - Department of Ophthalmology, Kameda Medical Center, Kamogawa, Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20200624
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
RN  - 31YO63LBSN (Nivolumab)
SB  - IM
MH  - Aged
MH  - Humans
MH  - Male
MH  - Nivolumab/adverse effects
MH  - *Panuveitis/chemically induced/diagnosis/drug therapy
MH  - *Retinal Detachment/chemically induced
MH  - *Uveitis
MH  - *Uveomeningoencephalitic Syndrome/chemically induced/diagnosis/drug therapy
PMC - PMC7313170
OTO - NOTNLM
OT  - Examination of cerebrospinal fluid
OT  - HLA-DR4
OT  - Immune checkpoint inhibitors
OT  - Immune related adverse events
OT  - Nivolumab
OT  - PD-1 inhibitor
OT  - Steroid pulse therapy
OT  - Vogt-Koyanagi-Harada disease
COIS- The authors declare that they have no competing interests.
EDAT- 2020/06/26 06:00
MHDA- 2021/05/15 06:00
PMCR- 2020/06/24
CRDT- 2020/06/26 06:00
PHST- 2019/09/18 00:00 [received]
PHST- 2020/06/16 00:00 [accepted]
PHST- 2020/06/26 06:00 [entrez]
PHST- 2020/06/26 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/06/24 00:00 [pmc-release]
AID - 10.1186/s12886-020-01519-5 [pii]
AID - 1519 [pii]
AID - 10.1186/s12886-020-01519-5 [doi]
PST - epublish
SO  - BMC Ophthalmol. 2020 Jun 24;20(1):252. doi: 10.1186/s12886-020-01519-5.