- |||||||||| Rituxan (rituximab) / Roche
AT THE CROSSROADS: POLYANGIITIS OVERLAP SYNDROME UNVEILED (Convention Center Exhibit Hall: Rapid Fire Area 4A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1784;
Polyangiitis overlap syndrome is indeed an interesting and rare title, as it reflects the diversity and complexity of vasculitis. (2)
- |||||||||| Rituxan (rituximab) / Roche
AN UNCOMMON CAUSE OF ACUTE RESPIRATORY DISTRESS SYNDROME: A CASE OF PULMONARY ALVEOLAR PROTEINOSIS (Convention Center Exhibit Hall: Rapid Fire Area 1D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1779;
Early recognition and prompt initiation of specific treatment modalities, including whole lung lavage and potential adjunctive therapies such as recombinant GM-CSF, are crucial in improving outcomes and preventing disease progression. Close long-term follow-up is essential to monitor disease activity, treatment response, and to address complications or recurrence.
- |||||||||| Rituxan (rituximab) / Roche
THE PUZZLING CASE OF THE RAPIDLY BLOOMING LUNG NODULES (Convention Center Exhibit Hall: Rapid Fire Area 3B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1761;
Untreated, PLG can lead to respiratory failure, central nervous system disease, or overt EBV-positive lymphoma. More awareness about PLG can lead to quicker diagnosis and treatment (1, 2).
- |||||||||| Rituxan (rituximab) / Roche
INTERSTITIAL LUNG DISEASE IN ANTISYNTHETASE SYNDROME (Convention Center Exhibit Hall: Poster Area 4) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1719;
Careful attention should be paid in the physical examination to extrapulmonary manifestations including dermatologic and musculoskeletal manifestations which can guide diagnostic workup and Rheumatology referral. Treatment should be undertaken with a multidisciplinary team.
- |||||||||| Soliris (eculizumab) / AstraZeneca, Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio, Rituxan (rituximab) / Roche
REFRACTORY SEROPOSITIVE NONTHYMOMATOUS MYASTHENIA GRAVIS IN MYASTHENIC CRISIS: A CASE REPORT (Convention Center Exhibit Hall: Poster Area 4) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1706;
Refractory seropositive non-thymomatous MG represents a significant management challenge, requiring innovative treatment approaches beyond current standard care. This case underscores the importance of personalized treatment strategies and the need for continued research into effective therapies for refractory MG.
- |||||||||| Darzalex (daratumumab) / J&J, Opsumit (macitentan) / Nippon Shinyaku, J&J
CLINICAL COURSE OF PULMONARY HYPERTENSION IN A PATIENT WITH MULTIPLE MYELOMA (Convention Center Exhibit Hall: Poster Area 4) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1696;
Initially, the patient had a good response to chemotherapy and PAH treatment, his pulmonary hypertension remained stable for many years, until both conditions flared simultaneously. This case provides insight into the complexity of treating group 5 PH associated with multiple myeloma.
- |||||||||| anastrozole / Generic mfg.
SUSPECTED ANASTROZOLE-INDUCED ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1682;
Her medical history included pulmonary embolism treated with Apixaban and breast cancer status post-mastectomy, currently on anastrozole. AAV, secondary to anastrozole, should be considered a potential diagnosis in any patient with cutaneous, renal, or pulmonary manifestations.
- |||||||||| Opdivo (nivolumab) / BMS
IMMUNE CHECKPOINT INHIBITOR-INDUCED SARCOIDOSIS IN A PATIENT WITH HIGH-GRADE UROTHELIAL CARCINOMA (Convention Center Exhibit Hall: Rapid Fire Area 4B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1659;
He completed 4 cycles of neoadjuvant chemotherapy (Cisplatin/Gemfibrozil) followed by a cystoprostatectomy with creation of neobladder. Our report aims to provide awareness and highlights an important irAE of ICIs, given their increasingly widespread utility, as prompt recognition and biopsy is necessary to distinguish it from malignancy progression and make proper treatment decisions.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
PEMBROLIZUMAB-INDUCED MYOSITIS AND RESPIRATORY FAILURE: CASE REPORT (Convention Center Exhibit Hall: Rapid Fire Area 4B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1656;
Our patient demonstrates a refractory case of Pembrolizumab-induced myositis leading to respiratory failure despite initiation of IVIG and steroids. As the indications for pembrolizumab are broadened, it becomes more important to focus on further research to minimize or address its most severe side effects including myositis-induced respiratory failure.
- |||||||||| Rituxan (rituximab) / Roche
DIFFUSE GROUND-GLASS OPACITIES AS THE PRESENTING MANIFESTATION OF MANTLE CELL LYMPHOMA (Convention Center Exhibit Hall: Rapid Fire Area 4B) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1654;
The appearance of diffuse ground-glass opacities can be challenging as broad considerations most commonly include acute alveolar diseases, infection, and interstitial lung disease. This case highlights that lymphoma should be on the differential for a patient with diffuse ground-glass opacities, especially for persistent symptoms refractory to standard pharmacologic therapies.
- |||||||||| Rituxan (rituximab) / Roche
A CASE OF GRANULOMATOSIS WITH POLYANGITIS MIMICKING MALIGNANCY (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1620;
High degree of suspicion and early initiation of treatment early is of the essence to improve the prognosis in GPA. This case highlights the importance of considering GPA as a differential in cases with pulmonary nodules even without upper respiratory involvement.
- |||||||||| Rituxan (rituximab) / Roche
SARCOIDOSIS-LIKE REACTION IN A PATIENT WITH NODAL MARGINAL ZONE LYMPHOMA: A CASE REPORT (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1604;
Treatment with bendamustine/rituximab led to symptom improvement and resolution of pleural effusion. Our case demonstrates the importance of considering lymphoma in patients with histological features resembling sarcoidosis, particularly when the clinical presentation deviates from typical sarcoidosis patterns due to different therapeutic and prognostic implications.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD), Opdivo (nivolumab) / BMS, Yervoy (ipilimumab) / BMS
A COLD CASE OF MISTAKEN IDENTITY (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1603;
Our case demonstrates the importance of considering lymphoma in patients with histological features resembling sarcoidosis, particularly when the clinical presentation deviates from typical sarcoidosis patterns due to different therapeutic and prognostic implications. The most common immune checkpoint inhibitor associated with sarcoid like reaction has been attributed to ipilimumab but there is an association with nivolumab, pembrolizumab, and anti
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
PEMBROLIZUMAB: TO CAVITATE OR NOT TO CAVITATE (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1602;
Lung biopsy and serial CT imaging are helpful for diagnosis. Temporary or permanent discontinuation of ICI with or without immunosuppressant is needed for most patients.
- |||||||||| Rituxan (rituximab) / Roche
THE ROLE OF CONNECTIVE TISSUE DISEASE IN LUNG CANCER AND UTILITY OF BRONCHOSCOPIC CRYOBIOPSY (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1596;
This case demonstrates how long standing immunosuppression and ILD can result in lung malignancy, even in young never smokers. Definitive diagnosis early in presentation is paramount, and bronchoscopic technique, including robotic bronchoscopy, EBUS, and cryobiopsy, should be considered to evaluate for malignancy and infection.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
SQUAMOUS CELL LUNG CARCINOMA WITH INTRACARDIAC TRANSMURAL INVASION AND LARGE MEDIASTINAL MASS (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1594;
While squamous cell lung carcinoma with extension into the left atrium remains a rare entity, clinicians should maintain a high index of suspicion for intracardiac involvement in patients presenting with SCC and cardiac symptoms. Further research and reporting of similar cases are warranted to enhance our understanding of the natural history, optimal diagnostic strategies, and treatment outcomes in this subset of patients.
- |||||||||| Ibrance (palbociclib) / Pfizer
RARE CASE OF THERAPY-RELATED ACUTE MYELOID LEUKEMIA FROM BREAST CARCINOMA MANAGEMENT WITH PALBOCICLIB (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1591;
Arimidex was also started but was eventually discontinued due to worsening lung nodules on PET/CT...She was started on Venetoclax and Azacitidine, her pancytopenia improved, however, has overall poor prognosis...Gemcitabine's anti-AML activity and short-term exposure for other treatments make them unlikely to trigger t-AML. This report encourages analysis of long-term genotoxic side-effects of Palbociclib in breast cancer management and bone marrow biopsy is crucial when prolonged pancytopenia exists post treatment.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
PRIMARY LUNG ADENOCARCINOMA PRESENTING WITH A SISTER MARY JOSEPH NODULE (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1584;
He also started chemotherapy with carboplatin-pemetrexed and pembrolizumab was added for immunotherapy. Even though extremely rare, evaluation for lung cancer should be considered for patients presenting with a Sister Mary Joseph nodule especially when there is no evidence of a primary abdominopelvic malignancy.
- |||||||||| Tecentriq (atezolizumab) / Roche
SEQUENTIAL PARANEOPLASTIC ENDOCRINE SYNDROMES IN SMALL CELL LUNG CANCER (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1580;
Our unique case represents the rare case of sequential presentation of two paraneoplastic disorders in the same patient with SCLC. Further research is needed to predict such cases in small cell lung cancer patients and their outcomes.
- |||||||||| Rituxan (rituximab) / Roche
A CASE OF HIV-ASSOCIATED THROMBOTIC THROMBOCYTOPENIC PURPURA (Convention Center Exhibit Hall: Rapid Fire Area 1C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1550;
iTTP is a rare life-threatening condition, and its association with HIV is well-documented. Clinicians should consider HIV testing as part of routine work-up when evaluating a patient for classic TTP.
- |||||||||| Cablivi (caplacizumab) / Sanofi, Rituxan (rituximab) / Roche
IMMUNE-MEDIATED THROMBOTIC THROMBOCYTOPENIC PURPURA WITHOUT THROMBOCYTOPENIA (Convention Center Exhibit Hall: Rapid Fire Area 1C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1545;
Her medications included aspirin 81 mg, atorvastatin 20 mg and valsartan 40 mg...The patient was readmitted to hospital for plasmapheresis in addition to intravenous solumedrol 2.5mg/kg/d... Our patient had atypical presentation of iTTP with normal platelet count and ADAMTS13 activity was monitored for managing treatment plan and clinical symptoms.
- |||||||||| Darzalex (daratumumab) / J&J
MULTIPLE MYELOMA IN RELAPSE: A RARE CAUSE OF CARDIAC TAMPONADE (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1534;
Early pericardiocentesis with fluid analysis is necessary for diagnosis and prognostication of pericardial effusions. There is no expert consensus on treatment of myelomatous pericardial effusion with tamponade.
- |||||||||| Opdivo (nivolumab) / BMS, Rituxan (rituximab) / Roche
PRIMARY MEDIASTINAL B-CELL LYMPHOMA IN A 19-YEAR-OLD MALE (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1516;
Patients with PMBCL usually present with advanced stage disease and symptoms due to local invasion of mediastinal structures. Prompt treatment with chemo-immunotherapy should be initiated.
- |||||||||| Ocrevus (ocrelizumab) / Roche
OCRELIZUMAB-INDUCED DIFFUSE CRYPTOGENIC ORGANIZING PNEUMONIA (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1499;
Further research is needed to elucidate the mechanisms underlying such adverse events and to guide appropriate patient management strategies. Healthcare providers should remain vigilant for respiratory symptoms in patients receiving ocrelizumab and consider thorough pulmonary evaluation in cases of unexplained respiratory distress.
- |||||||||| Rituxan (rituximab) / Roche
ANTISYNTHETASE PL-12 AND SJ?GREN'S DISEASE: AN UNCOMMON COMORBIDITY (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1483;
The characteristics of this syndrome are not well described. Our case highlights the significance of diagnosing these patients given its implications for prognosis and treatment.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
ANTI-OJ AUTOANTIBODIES AS AN EXACERBATING FACTOR IN PEMBROLIZUMAB-RELATED INTERSTITIAL LUNG DISEASE (ILD) (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1471;
CASE PRESENTATION: Our patient is a sixty-five year old male with history of pulmonary sarcoidosis, chronic hypoxic respiratory failure on three liters supplemental oxygen, obstructive sleep apnea on continuous positive airway pressure and stage IV NSCLC status post chemotherapy and immune therapy with Cisplatin, Pemetrexed and Pembrolizumab (PD-L1 humanized antibody) who presented with dyspnea and admitted for acute on chronic hypoxic respiratory failure within 1 month of Pembrolizumab initiation. We hypothesize that our patient rapidly developed new ILD due to the compounding effects of ICI pneumonitis and predisposition from anti-OJ autoantibodies.
- |||||||||| Shingrix (zoster vaccine recombinant adjuvanted) / GSK, Japan Vaccine
A RARE CASE OF SHINGRIX-ASSOCIATED DIFFUSE ALVEOLAR HEMORRHAGE (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1469;
Patient was initiated on steroids, broad-spectrum antibiotics, Micafungin, and Acyclovir...Patient was on Daratumumab, an immunotherapy targeting CD38 as well as Ninlaro, a proteasome inhibitor for his multiple myeloma... Although conventional vaccines like SHINGRIX are generally safe, clinicians should consider immune-mediated reactions such as diffuse alveolar hemorrhage (DAH) as a potential differential in vaccination-related adverse events.
- |||||||||| Dupixent (dupilumab) / Sanofi, Regeneron, Rituxan (rituximab) / Roche
RAPIDLY PROGRESSIVE INTERSTITIAL LUNG DISEASE IN SERONEGATIVE AMYOTROPHIC DERMATOMYOSITIS (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1466;
Early detection of patients with RP-ILD is critical with initiation of intensive treatment including immunosuppression and ruling out infection. However, it is unclear what treatment modalities improve the course in these patients which warrants further investigation.
- |||||||||| Rituxan (rituximab) / Roche
A RARE CASE OF NEUROMYELITIS OPTICA; DIFFERENTIATING IT FROM MULTIPLE SCLEROSIS (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1446;
Treatment was started with intravenous methylprednisolone 1g daily for 3 days...Subsequently, relapse prevention was started with rituximab 1g... NMO can be a challenging diagnosis due to its many similarities with MS therefore, clinicians should be aware of the diagnostic criteria and conduct investigations accordingly.
- |||||||||| Rituxan (rituximab) / Roche
UNMASKING WEGENER'S: A RARE CASE OF VASCULITIS IN A YOUNG ADULT (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1424;
The combination of ANCA Vasculitis with alveolar hemorrhage and ARDS represents a critical and potentially fatal condition, emphasizing the urgent need for swift identification and aggressive therapeutic intervention. ECMO serves as a vital intervention, bridging the gap between clinical deterioration and the onset of immunosuppressive therapy, thereby demonstrating its pivotal role in preserving patient lives.
- |||||||||| Rituxan (rituximab) / Roche
TRIPLE THREAT: A LIFE-THREATENING CONVERGENCE OF HYPERTENSIVE EMERGENCY, CARDIAC TAMPONADE, AND LUPUS NEPHRITIS (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1418;
ECMO serves as a vital intervention, bridging the gap between clinical deterioration and the onset of immunosuppressive therapy, thereby demonstrating its pivotal role in preserving patient lives. Although SLE can affect any organ system, and present with varying signs and symptoms, the presentation of tamponade, hypertensive emergency, and renal failure is rare.
- |||||||||| Monjuvi (tafasitamab-cxix) / Incyte
DIALYSIS DISEQUILIBRIUM SYNDROME: A RARE ENTITY IN MODERN MEDICINE (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1328;
The patient was complaining of increased nausea and vomiting, poor appetite and muscle weakness since starting third line Tafasitamab and Revlimid treatment for DLBCL two days back...She was then noted to have new onset tonic-clonic seizures and was given Ativan and Keppra... Despite being extremely rare, dialysis disequilibrium syndrome should always be considered in a patient with neurological manifestations after a session of hemodialysis.
- |||||||||| Piqray (alpelisib) / Novartis, Ibrance (palbociclib) / Pfizer
PI3K INHIBITOR-INDUCED HYPERGLYCEMIA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1288;
Use of insulin rather than oral antidiabetic therapy can result in better glucose tolerance as observed. Optimization of insulin use timing, based on the timing of intake of Alpesilib is important as Alpesilib causes insulin resistance through the mechanism described above.
- |||||||||| Rituxan (rituximab) / Roche
CLOT-ASTROPHE: NAVIGATING CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1268;
Our case illustrates the complexities associated with catastrophic antiphospholipid syndrome (CAPS), showcasing severe thrombotic complications impacting multiple organs. Reflecting on this scenario, we advocate for empiric treatment in suspected CAPS cases, acknowledging the importance of clinical judgment and adaptable interpretation until a definitive diagnosis is confirmed.
- |||||||||| Humira (adalimumab) / AbbVie, Rituxan (rituximab) / Roche
PULMONARY MUCORALES IN A PATIENT WITH FELTY SYNDROME (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1247;
Felty Syndrome is a rare complication of Rheumatoid Arthritis; the characteristic neutropenia and immunosuppressive treatment predispose patients to infection, including invasive fungal infections. Practitioners should have a high index of suspicion for atypical infections in this population.
- |||||||||| Tremfya (guselkumab) / J&J
THE UNSEEN DANGER: SYSTEMIC INVASIVE CAVITARY ASPERGILLOSIS DURING TREATMENT WITH GUSELKUMAB (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1213;
This report presents a case of invasive aspergillosis in a patient undergoing biologic treatment with Guselkumab for severe plaque psoriasis. This case reveals the importance of awareness and understanding of potential opportunistic infections that can develop during biological treatment so that appropriate interventions can be implemented at an early stage.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
BEYOND CANCER CONTROL: PEMBROLIZUMAB'S ROLE IN CARDIAC ARREST CASE (Convention Center Exhibit Hall: Poster Area 1) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1152;
Where development of direct cardiotoxic effects like myocarditis and arrhythmia are anticipated in patients treated with pembrolizumab, it is imperative to anticipate acute coronary syndrome too in patients being treated with pembrolizumab. An effective approach would be to check CRP levels in these patients as a predictor of early coronary events which was unfortunately not performed in our patient.
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