- |||||||||| Rituxan (rituximab) / Roche
EXPLORING THE INTERPLAY: IGA VASCULITIS PRESENTING WITH PULMONARY RENAL SYNDROME (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2997;
He was initiated on pulsatile doses of Solu-medrol for 3 days with remarkable improvement in his respiratory status...He was then started on rituximab 1g for a clinical diagnosis of IgAV presenting with DAH permitting a safe discharge with outpatient follow up... Pulmonary manifestations from IgAV are less common, but should remain in the differential, particularly in young adults with evidence of end organ damage.
- |||||||||| Rituxan (rituximab) / Roche
SUSPECTED SMOLDERING ANCA-ASSOCIATED VASCULITIS, A PULMONARY-RENAL PRESENTATION (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2986;
The development of life-threatening complications, such as pneumothorax and diffuse alveolar hemorrhage, may have been prevented by recognition and initiation of early treatment. This case serves to alert clinicians to take into consideration early warning signs of vasculitis, especially in the setting of multi-organ involvement.
- |||||||||| ROBOTIC BRONCHOSCOPY FOR DIAGNOSIS OF POLYMORPHOUS, PARENCHYMAL, POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER (PTLD) (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2969;
INTRODUCTION: Approximately 5% of bilateral lung transplant (BLT) recipients encounter posttransplant lymphoproliferative disorder (PTLD)[1], which commonly presents as lymphadenopathy and is sequentially treated with rituximab and cyclophosphamide-doxorubicin-vincristine-prednisone (R-CHOP)...CASE PRESENTATION: A 65-year-old female underwent uneventful BLT for rheumatoid arthritis (RA) associated interstitial lung disease in November 2023 with resultant good allograft function (FEV1 2.71L and FVC 3.1L); immunosuppression was induced with basiliximab and maintained with mycophenolate mofetil 500 mg BID, tacrolimus and prednisone...This was followed by vancomycin-resistant Enterococcus faecium bacteremia, treated with daptomycin and mycophenolate was stopped...Our patient's pre-transplant history of treatment of RA with tocilizumab (biologic) for 18 years may have predisposed her to PTLD... This is the first report of use of robotic bronchoscopy and R-TBCB for diagnosis of polymorphous parenchymal PTLD.
- |||||||||| Opdivo (nivolumab) / BMS, Yervoy (ipilimumab) / BMS
A RARE CASE OF SMARCA4-DEFICIENT MALIGNANCY (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2890;
SMARCA4-deficient undifferentiated tumors are a rare and lethal form of cancer. Although ICI and platinum-based regimens may show promise, development of novel therapeutic agents is warranted.
- |||||||||| ANEMIA'S DISCOVERY: GASTRIC METASTASIS UNMASKS PRIMARY LUNG CANCER (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2887;
Patients with known lung malignancy, significant smoking history or known solitary pulmonary nodule presenting with melena, dysphagia, and abdominal/epigastric pain should prompt evaluation for GMLC. Male smokers in their 4th or 5th decades are more prone to present with GMLC as per the limited reported cases.
- |||||||||| Imfinzi (durvalumab) / AstraZeneca
TO BOLDLY GO WHERE NO ONE HAS GONE BEFORE: NEOADJUVANT STRATEGIES IN NSCLC (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2881;
Given the substantial burden associated with advanced lung cancer, further research is imperative to delineate optimal treatment strategies for patients undergoing curative surgery. The question of whether neoadjuvant therapy should be standard practice for all lung cancer patients versus patients with limited-stage metastasis to the mediastinal lymph node, as suggested by the AEGEAN trial, remains open and warrants rigorous investigation.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
AN UNUSUAL CASE OF LUNG ADENOCARCINOMA CAMOUFLAGED BY PULMONARY FIBROSIS IN A HUMAN IMMUNODEFICIENT VIRUS PATIENT (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2880;
Cough did not respond to trials of PPI, antihistamines, albuterol inhalers or discontinuing lisinopril...Empirically started on steroids and Bactrim for pneumocystis jiroveci prophylaxis...However, he developed pneumonitis after first round of chemotherapy and immunotherapy (Keytruda) was discontinued... We aim to highlight the increase of lung cancers in PLHIV and bring attention to an uncommon presentation of adenocarcinoma that precluded early detection.
- |||||||||| Rituxan (rituximab) / Roche
TRACHEAL AND BRONCHIAL AIRWAY STENOSIS IN GRANULOMATOSIS WITH POLYANGIITIS (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2869;
GPA is a rare cause of distal airway stenosis but should be included in the differential diagnosis due to its asymptomatic nature and its incidental findings on imaging and bronchoscopy. More data is required for long-term outcome and treatment options to reduce restenosis.
- |||||||||| Rituxan (rituximab) / Roche
A RARE CASE OF NODULAR LUNG DISEASE ON A BACKGROUND OF LYMPHOMA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2772;
This case adds to the existing literature on the clinical or radiological manifestations of GOP. It suggests that patients with GOP and a history of malignancy follow a benign clinIcal course and can be managed conservatively with observation alone.
- |||||||||| POTENTIATION OF PD-L1- AND PD-1-INDUCED PNEUMONITIS (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2754;
There has been no large-scale study that evaluates the possibility of an "additive" effect on the risk of developing high grade, fatal pneumonitis when Durvalumab is used after Nivolumab. As clinical guidelines recommend increasing use of Durvulumab, the possibility of potentiated toxicity resulting from the interaction from these two immunotherapy agents warrants further investigation.
- |||||||||| Kimmtrak (tebentafusp-tebn) / Immunocore
MORE THAN MEETS THE EYE: LIFE-THREATENING CYTOKINE RELEASE SYNDROME FOLLOWING METASTATIC UVEAL MELANOMA TREATMENT WITH TEBENTAFUSP (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2726;
CRS was first documented in the 1990s with the use of anti-T-cell antibody muromonab-CD3 for immunosuppression following solid organ transplantation. While CRS is a notable adverse effect of tebentafusp-tebn, its presentation is highly variable and can rapidly progress to a dysregulated systemic inflammatory response requiring timely identification and multidisciplinary management of multiorgan system failure.
- |||||||||| Rituxan (rituximab) / Roche
SHOCKING CATASTROPHIC APLS (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2717;
She was discharged on low dose Prednisone and Coumadin. Urgent critical care and rheumatological consultation should be considered when there's clinical suspicion for CAPS.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
ACUTE PNEUMONITIS UNMASKED: A RARE CASE OF PEMBROLIZUMAB-INDUCED PULMONARY COMPLICATION (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2673;
Diagnosing this disease can be challenging due to the variability in onset, clinical severity and radiological presentations, hence identification of common symptoms like cough and dyspnea and rapid intervention is important to reduce mortality. Special attention should be given to patients with underlying lung disease.
- |||||||||| Rituxan (rituximab) / Roche
CHILLING COMPLICATIONS: COVID ASSOCIATED COLD AUTOIMMUNE HEMOLYTIC ANEMIA (AIHA) (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2670;
Despite an initially unremarkable presentation, the patient experienced a series of complications, including pulmonary emboli and deep vein thrombosis and required ICU admission. Through a collaborative approach involving hematology and critical care, the patient received targeted treatments and was stabilized and discharged with a tailored management plan.
- |||||||||| Ibrance (palbociclib) / Pfizer
IT'S NOT A ''MET!'': METACHRONOUS EYE CARCINOMA ON PREVIOUSLY METASTATIC BREAST CANCER (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2665;
Healthcare providers must monitor survivors of cancer for the potential development of MPM. Discussing follow-up plans and lifestyle modifications becomes essential to mitigate these risks and enhance the overall well-being of cancer survivors.
- |||||||||| Opdivo (nivolumab) / BMS, Rituxan (rituximab) / Roche, Yervoy (ipilimumab) / BMS
CHECKPOINT CONFUSION, ASEPTIC ENCEPHALITIS AFTER IMMUNE CHECKPOINT INHIBITOR THERAPY (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2646;
This case highlights the importance of consideration of aseptic encephalitis when working up encephalopathy in critically ill patients on ICPi therapy, especially when initial work-up is negative. Neurological irAEs are an increasingly described entity as ICPi usage expands.
- |||||||||| Cablivi (caplacizumab) / Sanofi, Rituxan (rituximab) / Roche
CANCER-ASSOCIATED THROMBOTIC MICROANGIOPATHY (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2641;
A multidisciplinary approach is needed to manage patients with CA-TMA. Chemotherapy along with supportive care is the primary treatment, though the prognosis is poor.
- |||||||||| Rituxan (rituximab) / Roche
A RARE CASE OF GEOTRICHUM CANDIDEMIA IN AN IMMUNOCOMPROMISED PATIENT (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2639;
Systemic Geotrichum Candidum is rare fungal infection in immunocompromised patients which if undetected can be fatal. Timely treatment with voriconazole is vital.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
TREATMENT OR TRIGGER? IMMUNE CHECKPOINT INHIBITOR-INDUCED MYASTHENIA GRAVIS IN A PATIENT WITH METASTATIC LUNG ADENOCARCINOMA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2633;
CASE PRESENTATION: A 79 year old male with stage IV adenocarcinoma of the lung receiving ICI therapy with pembrolizumab (three cycles given, last seven days prior) presented with three days of hypophonia and increased oral secretions... As the indications for ICI therapy continue to grow, clinicians will need to be more familiar with the various irAEs these medications may cause, particularly those associated with high morbidity and mortality, like ICI related myasthenia gravis.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma, Darzalex (daratumumab) / J&J, Kineret (anakinra) / SOBI
RSV-MEDIATED HLH IN THE SETTING OF MULTIPLE MYELOMA: A DIAGNOSTIC AND THERAPEUTIC CONUNDRUM (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2605;
Early recognition and treatment are essential for positive outcomes. Risks and benefits of alternative anti-inflammatory therapies like Tocilizumab and Anakinra should be weighed carefully and warrant further investigation
- |||||||||| Monjuvi (tafasitamab-cxix) / Incyte, Rituxan (rituximab) / Roche
A CASE OF PRIMARY PULMONARY PULMONARY NOCARDIOSIS IN A PATIENT WITH DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2566;
Pulmonary nocardiosis carries a significant morbidity and mortality in patients with hematologic malignancies and may imitate other common opportunistic infections or malignancy. In such instances, nocardiosis should be considered, either as a stand-alone diagnosis or co-infection, leading to aggressive diagnostic attempts in any immunocompromised patient failing to improve on existing therapies, with consideration of disseminated infection if pulmonary nocardiosis is confirmed.
- |||||||||| Rituxan (rituximab) / Roche, Imbruvica (ibrutinib) / AbbVie, J&J
PJP WITH TREE-IN-BUD NODULARITY: AN ABNORMAL PJP IMAGING FINDING (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2508;
Treatment with ibrutinib (Tyr-223 phosphorylation inhibitor) and oral dexamethasone 40 mg weekly was then started; bendamustine and rituximab were added 1 month prior to presentation for persistently elevated IgM levels...The patient was started on trimethoprim-sulfamethoxazole for suspected Pneumocystis jirovecci pneumonia (PJP); DNA was ultimately detected in the patient's induced sputum by PCR... Despite there being no clear recommendations, any concerning imaging findings or symptoms should prompt physicians to add PJP treatment if the patient is on immunosuppressive medications or there is a concern for HIV.
- |||||||||| Rituxan (rituximab) / Roche
A RARE CASE OF EVANS SYNDROME (Convention Center Exhibit Hall: Poster Area 1) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2479;
Initially, she was treated with prednisone tapering dose with minimal response...Rituximab, splenectomy or alternate options in patients not responding to standard treatment or steroid dependent. Although rare, Evans syndrome is life threatening and it is important to recognize its implications and manage appropriately.
- |||||||||| Rituxan (rituximab) / Roche
1025: Pulmonary Vasculitis: Evolving Approaches in Diagnosis and Management (Convention Center 206 AB) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2142;
Examine the evidence for use of plasma exchange, standardized glucocorticoids, rituximab, C5a receptor inhibitors, and anti-IL5 therapy for pulmonary AAV...4. Discuss bronchoscopic interventions for deforming or ulcerating upper airway lesions in pulmonary AAV.
- |||||||||| Soliris (eculizumab) / AstraZeneca, Rituxan (rituximab) / Roche
THE CRISIS OF POLYAUTOIMMUNITY: ANTIGLOMERULAR BASEMENT MEMBRANE DISEASE COMPLICATED BY ANTIPHOSPHOLIPID SYNDROME (Convention Center Exhibit Hall: Rapid Fire Area 2C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1988;
Given this patient's history of multiple spontaneous abortions, family history of APL along with presenting symptoms of coagulopathy, hemoptysis, renal failure and several autoantibodies the possibility of polyautoimmunity should be considered. The importance of early recognition of clinical features and subspecialty consultation for added intervention such as adjunct therapy is pivotal in improving survival.
- |||||||||| Rituxan (rituximab) / Roche
NAVIGATING COMPLEXITY: A CASE OF POLYANGIITIS OVERLAP SYNDROME PRESENTING WITH CARDIAC INVOLVEMENT (Convention Center Exhibit Hall: Rapid Fire Area 3D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1982;
PAOS is a clinical entity with overlapping features of EGPA and GPA and should be considered during diagnosis in vasculitis with eosinophilic features. By sharing this case, we aim to enhance awareness and improve the management of PAOS in clinical practice.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
ALL THAT IS RECURRENT IS NOT MALIGNANT! (Convention Center Exhibit Hall: Rapid Fire Area 3D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1979;
Chylothorax might not have a classic "milky white" appearance all the time. It is prudent to send the pleural fluid for triglyceride analysis especially if the effusion is recurrent and exudative.
- |||||||||| Rituxan (rituximab) / Roche
FROM TICK BITE TO HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS: A CASE REPORT (Convention Center Exhibit Hall: Rapid Fire Area 2A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1944;
In conclusion, this case offers valuable insights into a rare but lethal disease. Therefore, clinicians must maintain a high index of suspicion to identify this disease.
- |||||||||| Rituxan (rituximab) / Roche
DELAYED ONSET STATIN-INDUCED ANTI-HMGCR ANTIBODY-MEDIATED NECROTIZING AUTOIMMUNE MYOPATHY (Convention Center Exhibit Hall: Rapid Fire Area 1D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1940;
Eventually, the rheumatology team opted for rituximab therapy that resulted in significant alleviation of the symptoms... This case underscores the importance of considering statin-induced IMNM even after prolonged statin cessation and highlights successful treatment strategies.
- |||||||||| Opdivo (nivolumab) / BMS, Yervoy (ipilimumab) / BMS
A LIVER IN CRISIS: ACUTE LIVER FAILURE FOLLOWING IMMUNOTHERAPY IN A STAGE IV UVEAL MELANOMA PATIENT (Convention Center Exhibit Hall: Rapid Fire Area 2B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1932;
Although prompt management with cessation of ICI therapy and initiation of steroids do improve outcomes in some cases, prognosis is poor in regards to mortality. Hence, close monitoring of the clinical condition and liver function of patients receiving ICI may assist in early intervention.
- |||||||||| Rituxan (rituximab) / Roche
LYMPHOMATOID GRANULOMATOSIS: BRONCHOSCOPIC DIAGNOSIS IN THE SETTING OF PERSISTENT FEVER (Convention Center Exhibit Hall: Rapid Fire Area 4A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1907;
This case highlights the importance of identifying LYG as a possible contributor to pulmonary infiltrates, especially in individuals unresponsive to antibiotic treatment or experiencing unexplained fever. This acknowledgment of the potential diagnosis of LYG could facilitate early diagnosis and prognosis assessment, as well as provide guidance for directing patient care.
- |||||||||| Orencia (abatacept) / BMS, Keytruda (pembrolizumab) / Merck (MSD)
IMMUNE CHECKPOINT INHIBITOR INDUCED SEVERE OVERLAP SYNDROME: A CASE REPORT (Convention Center 256) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1883;
Understanding and recognizing the spectrum of complications linked to ICI therapy is vital for improving treatment outcomes. With increasing use of ICIs, further research is necessary to uncover the underlying pathophysiology, identify early biomarkers, and develop personalized interventions to enhance outcomes in patients with ICI-related overlap syndromes.
- |||||||||| Lynparza (olaparib) / Merck (MSD), AstraZeneca
TREATMENT OF SMALL CELL LUNG CANCER WITH OLAPARIB IN PATIENTS WITH A POSITIVE BRCA1 MUTATION (Convention Center 257 AB) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1859;
Concurrent chemoradiation therapy was started, with cisplatin and etoposide chemotherapy...Three months after completion of initial chemotherapy, the disease progressed in lungs, necessitating a rechallenge of chemoimmunotherapy (Carboplatin, Etoposide and Durvalumab)... Ultimately, our anecdotal experience with Olaparib, in this particular patient, seems to be revealing prolonged clinical meaningful benefit, warranting further investigations.
- |||||||||| sunvozertinib (DZD9008) / Dizal Pharma
SUCCESSFUL SUNVOZERTINIB RECHALLENGE FOR ADVANCED LUNG ADENOCARCINOMA WITH HER2 EXON20 INSERTION MUTATION: A CASE REPORT (Convention Center 257 AB) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1858;
In December, he exhibited pronounced cough, sputum production, and dyspnea leading to self-administration of dacomitinib 45mg once daily plus anlotinib 12mg once daily orally (Figure 1D)... For NSCLC with HER2 exon20ins, sunvozertinib demonstrates efficacy in posterior-line therapy with tolerable adverse reactions, and remains effective upon re-challenge due to non-progressive factor.
- |||||||||| Rituxan (rituximab) / Roche
A CASE OF RAPIDLY PROGRESSIVE NEURO-SJOGREN'S DISEASE RESULTING IN RESPIRATORY FAILURE (Convention Center 258 B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1844;
Sjogren's disease presenting with neurological symptoms is rare and often difficult to differentiate from other neurologic conditions. This case highlights a severe case of neuro-Sjogren's disease that was highly resistant to treatment, eventually requiring mechanical ventilation for neuromuscular weakness.
- |||||||||| Rituxan (rituximab) / Roche
GRANULOMATOSIS WITH POLYANGIITIS UNMASKED BY DIGITAL NECROSIS IN A PATIENT WITH SHOCK (Convention Center Exhibit Hall: Rapid Fire Area 4A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1785;
We wish to raise awareness regarding these heterogeneous manifestations that may be misdiagnosed as malignancy or infection. We present a case in which digital necrosis provided a late clue to the diagnosis of GPA.
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