Severe Epididymo‐Orchitis and Encephalitis Complicating Anti‐PD‐1 Therapy

We describe herein a patient with metastatic melanoma who developed epididymo‐orchitis followed by encephalitis while receiving pembrolizumab. The patient developed testicular pain and fever after his third dose of pembrolizumab; ultrasound evaluation demonstrated bilateral epididymo‐orchitis. He then developed headaches, fever, and altered mental status over the next week and was admitted to the hospital. Lumbar puncture revealed inflammatory changes consistent with meningoencephalitis; he did not improve with broad‐spectrum antibiotics, and an extensive workup for infectious etiologies, including cerebrospinal fluid testing using a clinical metagenomic next‐generation sequencing assay, was negative. He received high‐dose steroids for suspected autoimmune encephalitis, and both his orchitis and meningoencephalitis improved rapidly after one dose. He fully recovered after a 5‐week taper of oral steroids.Discussion.Here, we report a case of epididymo‐orchitis complicating immune checkpoint inhibitor therapy. This patient subsequently developed severe encephalitis but rapidly improved with steroids. Clinicians should be aware of rare complications of these agents.Key Points. Epididymo‐orchitis is a rare and potentially life‐threatening complication of anti‐programmed death protein 1 (anti‐PD‐1) therapy.For patients on anti‐PD‐1 therapy who develop either epididymo‐orchitis or epididymitis without clear infectious cause, immune‐related adverse eve...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Melanoma and Cutaneous Malignancies Immune ‐ Related Adverse Events Source Type: research

Related Links:

Publication date: Available online 24 September 2020Source: The Lancet Respiratory MedicineAuthor(s): Anna Schultze, Alex J Walker, Brian MacKenna, Caroline E Morton, Krishnan Bhaskaran, Jeremy P Brown, Christopher T Rentsch, Elizabeth Williamson, Henry Drysdale, Richard Croker, Seb Bacon, William Hulme, Chris Bates, Helen J Curtis, Amir Mehrkar, David Evans, Peter Inglesby, Jonathan Cockburn, Helen I McDonald, Laurie Tomlinson
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research
Publication date: Available online 24 September 2020Source: The Lancet Respiratory MedicineAuthor(s): Dave Singh, David M G Halpin
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research
Objective: The menopausal transition has a negative effect on peripheral dilation in response to various stimuli including shear stress and exercise. Whether the presence of elevated traditional cardiovascular disease (CVD) risk factors in women going through menopause exacerbates the adverse effect on peripheral vasodilation is unclear. Methods: Forty-four perimenopausal women with relatively low CVD risk were divided into tertiles based on atherosclerotic CVD (ASCVD) 10-year risk scores (lowest: 0.1%-0.5%, middle: 0.6%-0.9%, higher:>1%). Comparisons were made across tertile groups for the femoral artery vascular ...
Source: Menopause - Category: OBGYN Tags: Brief Report Source Type: research
Selective estrogen receptor modulators (SERMs) are an increasingly important therapeutic modality that are used by clinicians on a daily basis. Unfortunately, clinicians have a limited understanding regarding the underlying mechanism(s) of how SERMs function and their increasingly useful role in the treatment of estrogen-responsive target tissues such as the breast, bone, vagina, uterine endometrium, and brain. This review will provide a basic understanding of our current knowledge of SERM pharmacodynamics and will highlight the clinical applications of Food and Drug Administration–approved SERMs in the treatment of ...
Source: Menopause - Category: OBGYN Tags: Clinical Corner: Invited Review Source Type: research
Conclusions and Relevance: Lacking strong evidence indicating significant patient risk for vaginal laser treatment of GSM, the FDA safety communication appears unsubstantiated and implies gender bias. Identified complications suggest most reported “adverse events” represent lack of treatment effect. The well-documented benefits and low risk of adverse event suggest laser therapy for GSM is reasonable with appropriate pretreatment counseling. Additional randomized, well-controlled clinical trials are needed to further elucidate both the safety and efficacy of this nonhormone therapy.
Source: Menopause - Category: OBGYN Tags: Review Articles Source Type: research
This study aimed to assess the symptom burden in the last 6 months of life in a real-world cohort. METHODS: Patients diagnosed with metastatic gynaecologic malignancies from 2016 to 2019 who completed the revised Edmonton Symptom Assessment System (ESASr) questionnaire within 6 months of death in a large Canadian province were identified. Patient-reported symptom scores were categorized as none to mild (0-3) and moderate to severe (4-10). Individual symptoms were subsequently grouped into physical, psychological, and total subscores. The severity of symptoms was further analyzed for any associations with age, time to d...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Publication date: 26 September–2 October 2020Source: The Lancet, Volume 396, Issue 10255Author(s): Andrew W Horne, Katy Vincent, Catherine A Hewitt, Lee J Middleton, Magda Koscielniak, Wojciech Szubert, Ann M Doust, Jane P Daniels, Suraiya Abdi, Santanu Acharya, Shamma Al-Inizi, Elizabeth Ball, Andrew Baranowski, Nadia Bhal, Kalsang Bhatia, Siladitya Bhattacharya, Judy V. Birch, Tyrone Carpenter, Tony Chalhoub, Ying C. Cheong
Source: The Lancet - Category: General Medicine Source Type: research
Publication date: Available online 24 September 2020Source: Pharmacology &TherapeuticsAuthor(s): Kristen Fousek, Lucas A. Horn, Claudia Palena
Source: Pharmacology and Therapeutics - Category: Drugs & Pharmacology Source Type: research
Authors: Shen GN, Li J, Jin YH, Sun HN, Hao YY, Jin MH, Liu R, Li WL, Zhang YQ, Yu JB, Yu NN, Wang WD, Yu LY, Kim JS, Kwon T, Han YH Abstract The aim of the present study was to verify the pro-apoptotic anticancer potential of several 5,8-dimethoxy-1,4-phthoquinone (DMNQ) derivatives in Ras-mediated tumorigenesis. MTT assays were used to detect cellular viability and flow cytometry was performed to assess intracellular reactive oxygen species (ROS) levels and apoptosis. The expression levels of proteins were detected via western blotting. Among the 12 newly synthesized DMNQ derivatives, 2-benzylthio-5,8-dimethoxyna...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Authors: Huang R, Li A Abstract Sperm-associated antigen 5 (SPAG5) is involved in the tumorigenesis of multiple cancer types. However, the role of SPAG5 during lung adenocarcinoma (LUAD) progression remains to be fully elucidated. In the present study, the expression of SPAG5 in tumor tissues of patients with LUAD from public cancer databases was analyzed using the online software Gene Expression Profiling Interactive Analysis and University of Alabama Cancer Database. The association of SPAG5 expression levels with the prognosis of patients with LUAD was analyzed using Kaplan-Meier Plotter. In addition, the role o...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
More News: Cancer | Cancer & Oncology | Corticosteroid Therapy | Encephalitis | Headache | Hospitals | Lumbar Puncture | Melanoma | Men | Oral Cancer | Pain | Skin Cancer | Ultrasound