Nivolumab-induced Vogt-Koyanagi-Harada-like Syndrome and Adrenocortical Insufficiency with Long-term Survival in a Patient with Non-small-cell Lung Cancer

Ryota Ushio; Masaki Yamamoto; Atsushi Miyasaka; Tatsuya Muraoka; Hiromi Kanaoka; Hironori Tamura; Ayami Kaneko; Ami Izawa; Nobuyuki Hirama; Shuhei Teranishi; Saki Manabe; Tatsuya Inoue; Kunihiko Shibata; Yasuyuki Sugiura; Makoto Kudo; Takeshi Kaneko

doi:10.2169/internalmedicine.6410-20

CASE REPORTS

Nivolumab-induced Vogt-Koyanagi-Harada-like Syndrome and Adrenocortical Insufficiency with Long-term Survival in a Patient with Non-small-cell Lung Cancer

Ryota Ushio, Masaki Yamamoto, Atsushi Miyasaka, Tatsuya Muraoka, Hiromi Kanaoka, Hironori Tamura, Ayami Kaneko, Ami Izawa, Nobuyuki Hirama, Shuhei Teranishi, Saki Manabe, Tatsuya Inoue, Kunihiko Shibata, Yasuyuki Sugiura, Makoto Kudo, Takeshi Kaneko

Author information

Ryota Ushio
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Masaki Yamamoto
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Atsushi Miyasaka
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Tatsuya Muraoka
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Hiromi Kanaoka
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Hironori Tamura
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Ayami Kaneko
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Ami Izawa
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Nobuyuki Hirama
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Shuhei Teranishi
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Saki Manabe
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Tatsuya Inoue
Ophthalmology Department, Yokohama City University Medical Center, Japan
Kunihiko Shibata
Otolaryngology, Head and Neck Surgery Department, Yokohama City University Medical Center, Japan
Yasuyuki Sugiura
Endocrinology Diabetes and Metabolism Department, Yokohama City University Medical Center, Japan
Makoto Kudo
Respiratory Disease Center, Yokohama City University Medical Center, Japan
Takeshi Kaneko
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Japan

Keywords: non-small-cell lung cancer, immune-related adverse events, Vogt-Koyanagi-Harada-like syndrome, adrenocortical insufficiency, HLA-DR4

JOURNAL OPEN ACCESS

2021 Volume 60 Issue 22 Pages 3593-3598

DOI https://doi.org/10.2169/internalmedicine.6410-20

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Abstract

A 58-year-old man was diagnosed with lung adenocarcinoma with a tumor proportion score of 10%. After six cycles of second-line chemotherapy with nivolumab, he achieved a complete response (CR) but developed uveitis and sensorineural hearing disorder, which were consistent with Vogt-Koyanagi-Harada (VKH)-like syndrome. Simultaneously, pituitary adrenocortical insufficiency was identified. Nivolumab discontinuation and systemic corticosteroid administration resolved these immune-related adverse events (irAEs). The patient has maintained a CR without any chemotherapy for approximately two years. We herein report a patient with a long-term progression-free survival despite chemotherapy discontinuation due to irAEs, including VKH-like syndrome, which were appropriately managed.

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