Nivolumab induced remitting seronegative symmetrical synovitis with pitting edema in a patient with melanoma: a case report

Journal of Medical Case Reports
Linh NgoElie Gertner

Abstract

Novel immune checkpoint inhibitors have been often utilized for different types of malignancies as salvage therapy with varying success. One obstacle to immune checkpoint inhibitor use is the higher incidence of immune-mediated side effects that can prompt discontinuation of therapy. Remitting seronegative symmetrical synovitis with pitting edema has been described with immune checkpoint inhibitors only once previously. We report a case of a patient who developed remitting seronegative symmetrical synovitis with pitting edema related to immune checkpoint inhibitor therapy and stress that these symptoms can be managed without cessation of immune checkpoint inhibitor therapy. We present a 70-year-old white man who presented with 4 months of progressive inflammatory arthritis with pitting edema. He had been started on nivolumab therapy for his metastatic melanoma with excellent response prior to symptom onset. The symptoms started in his knees and subsequently involved both hands and feet. On evaluation, he was wheelchair bound and completely dependent for all activities of daily living. Evaluation revealed negative serological testing and plain film imaging. Ultrasound demonstrated diffuse flexor tenosynovitis and soft tissue swe...Continue Reading

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Citations

Mar 15, 2019·Current Opinion in Rheumatology·Xerxes PundoleMaria E Suarez-Almazor
May 15, 2020·International Journal of Molecular Sciences·Konstantinos MelissaropoulosDimitrios Daoussis
Dec 10, 2019·Rheumatology·Noha Abdel-Wahab, Maria E Suarez-Almazor
Jan 20, 2019·Current Rheumatology Reviews·Fusun Gediz, Senol Kobak
Nov 30, 2019·Case Reports in Rheumatology·Bicky ThapaCassandra Calabrese
Dec 10, 2019·Rheumatology·Jan Leipe, Xavier Mariette
Oct 31, 2020·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Mounika LakhmallaFarah Wani
May 17, 2021·Joint, Bone, Spine : Revue Du Rhumatisme·Aude HansmaennelDaniel Wendling

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