- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
IMMUNE CHECKPOINT INHIBITOR-ASSOCIATED ACUTE LIVER FAILURE (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5303;
Steroids and immunosuppressant are mainstay therapies for severe immune-related adverse events. However, management may involve additional therapies such as plasma exchange to mitigate innate immune response that is rampant in acute liver failure.
- |||||||||| Rituxan (rituximab) / Roche, Zavicefta (ceftazidime/avibactam) / Pfizer, AbbVie
BALANCING TREATMENTS: A DIFFICULT AIRWAY WITH MYASTHENIA GRAVIS-ACQUIRED HEMOPHILIA AND PNEUMONIA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5299;
Rare diseases like MG and AHA require active collaborations and integrations between different specialists, including critical care, neurology, and hematology for optimal outcomes. This case demonstrates a complex example of when ICU treatments may conflict, and emphasizes the importance of multidisciplinary collaborations.
- |||||||||| Feiba (anti-inhibitor coagulant complex) / Takeda, Rituxan (rituximab) / Roche
THE CLOTTING CONUNDRUM: FATAL RECURRENT HEMATOMAS IN A CRITICALLY ILL PATIENT - A RARE CARE OF ACQUIRED HEMOPHILIA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5238;
Additional options include steroids and immunomodulators like cyclophosphamide and rituximab. This case emphasizes the importance of prompt workup of prolonged PTT to clinch the diagnosis of acquired hemophilia in patients with life threatening bleeding that is otherwise unexplained.
- |||||||||| Cubicin (daptomycin) / Merck (MSD), Rituxan (rituximab) / Roche
I GOT SEPTIC PULMONARY EMBOLI FROM MY ACNE?! (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5166;
This case emphasizes the potential of developing SPE from skin and soft tissue infections, and a negative echocardiogram does not preclude this. The selection of appropriate antibiotics is of utmost importance as demonstrated in our patient who worsened while on Daptomycin which is known to be inactivated by surfactant.
- |||||||||| Cytovene (ganciclovir) / Roche, Rituxan (rituximab) / Roche
HSV PNEUMONITIS: THE COVID MASQUERADER (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5148;
HSV Pneumonitis can be easily overlooked as a superinfection in COVID pneumonia, and may cause life-threatening pneumonitis. Clinicians should be aware of the risk of viral superinfection especially in immunocompromised patients with COVID pneumonia.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
PEMBROLIZUMAB-INDUCED CARDIOMYOPATHY (Convention Center Exhibit Hall: Poster Area 1) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5069;
Although ICI-induced myocarditis is a known phenomenon, it is a rare life-threatening condition that cannot be overlooked in patients presenting with chest pain in the setting of recent ICI initiation. Our case demonstrates the severity and management of ICI-induced myocarditis.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
TRYING TO BE CANCER-FREE AT THE COST OF THE HEART: A RARE CASE OF IMMUNE CHECKPOINT INHIBITOR-ASSOCIATED MYOCARDITIS (Convention Center Exhibit Hall: Poster Area 1) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5024;
Diagnosis and management of ICI-associated myocarditis is challenging, but continues to evolve with ongoing research. This case emphasizes the importance of vigilance and awareness of prompt recognition, discontinuation of immunotherapy, and initiation of steroids with a multidisciplinary approach in patients with ICI-associated myocarditis, among other irAEs.
- |||||||||| A CASE OF REFRACTORY IMMUNE THROMBOCYTOPENIA IN THE SETTING OF ABDOMINAL SPLENOSIS (Convention Center Exhibit Hall: Rapid Fire Area 2B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4985;
CASE PRESENTATION: A 25-year-old woman with known ITP (s/p prior splenectomy and previous admissions requiring IVIG and high dose Dexamethasone, and currently on daily Prednisone) presented with severe thrombocytopenia (platelet level of 4000/uL) during a routine hematology visit...Over the subsequent several weeks of hospital stay, the patient was trialed on IVIG, Prednisone, Mycophenolate Mofetil, Vincristine, and eventually, weekly Romiplostim and Rituximab...Since discharge, the patient is being treated with twice weekly platelet transfusions and Zarxio, and weekly romiplostim and Fostamatinib, with platelet numbers more recently starting to recover (currently 42000/uL). Here is a unique case of a patient with thrombocytopenia secondary to ITP that was refractory to all available treatments, including splenectomy, Rituximab and thrombopoietin receptor agonists.[7] Given prior case reports with recurrent ITP in the setting of abdominal splenosis, it is worthwhile to explore the connection between recurrent ITP with patients with presence of abdominal splenosis.
- |||||||||| Darzalex (daratumumab) / J&J
CRAZY PAVING, CHEMICALS, AND AMYLOIDOSIS: ALL FOR ONE, OR ONE FOR ALL? (Convention Center 253 C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4914;
Medical history was most significant for AL Amyloidosis (recently started on Dexamethasone/Daratumumab/Pomalidomide), systolic and diastolic CHF, moderate-to-severe mitral regurgitation, and atrial fibrillation recently started on Amiodarone...He was started on 1mg/kg of prednisone with a slow taper to follow along with PJP prophylaxis...Pomalidomide is a very rare but known cause of chemical pneumonitis and can cause eosinophilic pneumonia. It is challenging to differentiate Amiodarone toxicity from other chemically-induced pneumonitis, but the presence (or lack-there-of) of foamy macrophages that stain PAS+ may help.
- |||||||||| Adcetris (brentuximab vedotin) / Takeda, Pfizer
ENIGMA OF SHOCK (Convention Center Exhibit Hall: Rapid Fire Area 2D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4819;
ALCL is not commonly seen in routine clinical practice, and it requires a high index of suspicion for diagnosis, especially in the setting of high fever of non-infectious origin. In cases of unexplained septic shock, refractory lactic acidosis despite appropriate treatment, clinicians should suspect underlying undiagnosed lymphoproliferative neoplasm in the setting of severely elevated WBCs.
- |||||||||| Rituxan (rituximab) / Roche
ROLE OF ENDOTHELIN-1 IN CLINICAL OF SYSTEMIC SCLEROSIS ASSOCIATED WITH INTERSTITIAL LUNG DISEASE (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4742;
This may indirectly confirmed, that scleroderma patients present with high level of ET-1 seem to correlate with the severity of the disease and lung damage. Thus, a decrease in ET-1 during rituximab therapy, may indicate a positive response to therapy.
- |||||||||| Rituxan (rituximab) / Roche
TNF-ALFA IN SYSTEMIC SCLEROSIS: CLINICAL AND LABORATORY ASSOCIATION (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4741;
Thus, a decrease in ET-1 during rituximab therapy, may indicate a positive response to therapy. All patients received low or moderate dose glucocorticoids and immunosuppressants, 45 (68%) received rituximab (RTM) at cumulative dose 2.4
- |||||||||| Opdivo (nivolumab) / BMS
PULMONARY BLASTOMA: A RARE PRIMARY LUNG MALIGNANCY (Convention Center Exhibit Hall: Rapid Fire Area 3C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4583;
The primary treatment is surgical resection; however, chemotherapy, radiotherapy, immunotherapy, targeted therapy, or a combination of treatment modalities should be considered potential therapeutic strategies for PB and require a multidisciplinary approach. Due to the rarity of the cases, multicenter collaboration is warranted to conduct clinical trials and establish therapeutic guidelines for PB.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
A CASE OF PEMBROLIZUMAB-INDUCED PULMONARY HYPERTENSION AND PLEURAL EFFUSION (Convention Center Exhibit Hall: Rapid Fire Area 4C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4521;
More than one side effect can occur simultaneously, such as in our patient. This case underlines the importance of diligent workup necessary to reach the diagnosis as it is of exclusion.
- |||||||||| PRIMARY PLEURAL EFFUSION POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER IN A LUNG TRANSPLANT RECIPIENT: AN UNUSUAL PRESENTATION (Convention Center 253 C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4379;
PERTINENT LAB DATA: Chest CT 2 weeks later (7 weeks post-LT): numerous new solid pulmonary nodules bilaterally.EBV IgG antibody to nuclear and viral capsid antigens: positive (201 and >750 U/mL, respectively).Serum EBV DNA PCR: <125 copies/mL.Cryobiopsy of lung nodules: EBV+ polymorphic PTLD (CD20, CD79a, MUM1, BCL-6 and EBER-ISH positive).Follow-up: Treatment: Cycle1: R-CHOP with 25% dose reduction in cyclophosphamide due to CKD, complicated by severe pancytopenia and sepsis with vancomycin-resistant Enterococcus faecium bacteremia...The risk of PTLD is also influenced by the choice of induction agent, with ATG and alemtuzumab carrying a higher risk than basiliximab. We hypothesize that this patient's tocilizumab treatment prior to LT, in combination with basiliximab induction, increased the risk of PTLD, despite matched +EBV serostatus.
- |||||||||| Simulect (basiliximab) / Novartis
A COMPARISON OF BIOPSY-PROVEN ACUTE CELLULAR REJECTION RATES BASED ON MYCOPHENOLATE DOSING (Convention Center Exhibit Hall: Poster Area 4) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3990;
A statistically significant difference in ACR scores was not detected between patients who were maintained on MMF 1 gram twice per day during each of their bronchoscopies within the first year relative to patients who were at a lower dose. CLINICAL IMPLICATIONS: MMF dose reduction due to adverse side effects may be considered with reassurance against significant changes in ACR scores.
- |||||||||| Nulojix (belatacept) / BMS
IMPACT OF BELATACEPT INITIATION ON ANTIBODY-MEDIATED REJECTION EVOLUTION IN HIGHLY SENSITIZED PATIENTS (Convention Center Exhibit Hall: Poster Area 4) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3986;
Our study was limited by a relatively small sample size, but findings suggest that belatacept may have therapeutic potential in moderately sensitized patients (PRA <80%, MFI <1000) by reducing DSA burden without adverse effects on lung allograft function. CLINICAL IMPLICATIONS: Belatacept may aid in stabilizing the antibody burden among lung transplant recipients while maintaining graft and renal function.
- |||||||||| Rituxan (rituximab) / Roche
PREDICTORS OF NONRESPONSE TO IMMUNOSUPPRESSANTS IN NON-IPF ILD: A SINGLE-CENTER RETROSPECTIVE STUDY (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3680;
Although traction bronchiectasis is acknowledged as a negative prognostic indicator, our results emphasize the need for larger studies to assess its impact on the efficacy of immunosuppression in ILD patients. CLINICAL IMPLICATIONS: This study identifies traction bronchiectasis as a predictor for non-response to immunosuppressive therapy in non-IPF ILD patients, aiding treatment decisions and calling for further research.
- |||||||||| Rituxan (rituximab) / Roche
INTERSTITIAL LUNG DISEASE ASSOCIATED WITH SYSTEMIC SCLEROSIS WITH LATE ONSET AND EFFICIENCY OF ANTI-B-CELL THERAPY (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3651;
Serum level of IL-6 did not significantly change in our study, but it was correlated with FVC, DLCO and other evaluated parameters. Anti-B-Cell therapy (rituximab (RTX) improves lung function in many studies and clinical observations in SSc, but most of them was in early onset of the disease...All patients received prednisone at a dose of 12.2
- |||||||||| hydralazine hydrochloride / Generic mfg.
AN ACUTE ONSET OF HYDRALAZINE-ASSOCIATED ANCA VASCULITIS (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3622;
Hydralazine induced AAV can occur after < 7 days of exposure and can have opthalmologic, dermatologic, pulmonary and renal manifestations. Larger studies are needed to confirm conclusions.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma, Rituxan (rituximab) / Roche
PROGRESSIVE CAVITATION OF PULMONARY NECROTIZING GRANULOMAS IN RHEUMATOID ARTHRITIS: A CASE REPORT (Convention Center Exhibit Hall: Rapid Fire Area 4D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3367;
Multidisciplinary collaboration is essential for accurate diagnosis and optimal management, emphasizing the need for personalized treatment strategies to mitigate complications and improve patient outcomes. Further research is warranted to elucidate the underlying mechanisms and optimize therapeutic approaches for this rare but clinically significant condition.
- |||||||||| Rituxan (rituximab) / Roche
ENDOBRONCHIAL MUCOSAL VARICES IN A PATIENT WITH FIBROSING MEDIASTINITIS (Convention Center Exhibit Hall: Rapid Fire Area 3B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3355;
Albeit rare, FM can be devastating for patients if compression of vital mediastinal structures is severe. Prompt evaluation and diagnosis of FM via CT and bronchoscopy are crucial to early identification and potential treatment.
- |||||||||| Rituxan (rituximab) / Roche
A RARE AND RAPID DEVELOPMENT OF A PENETRATING THORACIC AORTIC ULCER FOLLOWING EXPOSURE TO CHEMOTHERAPY (Convention Center Exhibit Hall: Rapid Fire Area 1C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3348;
She underwent induction chemotherapy with methotrexate, rituximab, and temozolomide from May to September...While there is limited evidence linking chemotherapy with PAU, a case report demonstrated the rapid progression of PAU into a saccular aneurysm following treatment with anthracycline and cytarabine... Physicians should be cautious when administering chemotherapy as it can potentially contribute to the development or progression of PAU, particularly in patients with pre-existing risk factors.
- |||||||||| Rituxan (rituximab) / Roche
THE CONTEMPORARY EQUIVALENT OF LUETIC AORTITIS (Convention Center Exhibit Hall: Rapid Fire Area 1C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3341;
In addition, it must be noted that there are a lack of treatment guidelines following surgical treatment for IgG4 Aortitis since IgG4 levels can remain elevated without active disease. Only 30% with high IgG4 levels had relapse [1].
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
CYSTIC CAVITARY LUNG METASTASIS: A RARE PRESENTATION OF METASTATIC ENDOMETRIAL SQUAMUS CELL CARCINOMA (Convention Center Exhibit Hall: Rapid Fire Area 4A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3287;
Clinicians must maintain a broad differential diagnosis, especially when dealing with patients from endemic areas where conditions like tuberculosis are prevalent. In such cases, a thorough evaluation and consideration of the patient's medical history, including any previous cancer diagnoses, can aid in timely diagnosis and appropriate management.
- |||||||||| Imfinzi (durvalumab) / AstraZeneca
INFLIXAMAB-A SAVIOUR IN SEVERE EARLY ONSET DURVALUMAB-INDUCED PNEUMONITIS? (Convention Center Exhibit Hall: Rapid Fire Area 3D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3262;
Given the inability to wean her oxygen and no improvement in interval imaging, she underwent bronchoscopy with BAL, and her antibiotic coverage was broadened to include meropenem, micafungin, and prophylactic bactrim for PJP prophylaxis... Further research is warranted to understand the pathophysiology, risk factors, and biomarkers of CIP and optimize diagnosis and management.
- |||||||||| Opdivo (nivolumab) / BMS, Yervoy (ipilimumab) / BMS
PSEUDO PROGRESSION OF LUNG ADENOCARCINOMA AFTER NEOADJUVANT TREATMENT WITH IMMUNOTHERAPY (Convention Center Exhibit Hall: Rapid Fire Area 3D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3258;
The physician caring for patients receiving these therapies must be aware of pseudoprogression to avoid the risk of discontinuing treatments prematurely, especially in the context of neoadjuvant therapies in patients treated with curative intent. This case underscores the need for histological assessment and confirmation of such instances.
- |||||||||| Darzalex (daratumumab) / J&J
A CASE OF BRONCHIECTASIS FOLLOWING CHIMERIC ANTIGEN RECEPTOR T CELL THERAPY (Convention Center Exhibit Hall: Rapid Fire Area 1B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3254;
Patients post CAR-T therapy can develop bronchiectasis and recurrent infections requiring IVIG treatment. More studies are needed to evaluate features of bronchiectasis post CAR-T and target levels for immunoglobulin therapy in this population.
- |||||||||| Tavneos (avacopan) / Amgen, Rituxan (rituximab) / Roche
PR3 ANCA VASCULITIS PRESENTING AS NONRESOLVING PNEUMONIA FOLLOWING COVID-19 INFECTION (Convention Center Exhibit Hall: Poster Area 4) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3016;
Early diagnosis and treatment are crucial to improving mortality in GPA. Younger patients may not fit the characteristic clinical picture and require a high degree of suspicion.
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