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Organizing Pneumonia as a Side Effect of Ipilimumab Treatment of MelanomaPulmonary Complications of Ipilimumab Therapy

Igor Z. Barjaktarevic, MD; Nida Qadir, MD; Anu Suri, MBBS; Jean T. Santamauro, MD, FCCP; Diane Stover, MD, FCCP
Author and Funding Information

From the New York Presbyterian Hospital (Drs Barjaktarevic and Qadir), Weill Cornell Medical Center; and the Memorial Sloan-Kettering Cancer Center (Drs Suri, Santamauro, and Stover), Weill Cornell Medical College of Cornell Unversity, New York, NY.

Correspondence to: Igor Z. Barjaktarevic, MD, 11346 Iowa Ave, Apt PH7, Los Angeles, CA 90025; e-mail: barjaktarevic@gmail.com


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(3):858-861. doi:10.1378/chest.12-1467
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Ipilimumab is one of the newly developed human monoclonal antibodies used in the treatment of metastatic melanoma. Its primary mechanism of action is a specific blockade of cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), a T-cell receptor responsible for inhibition of lymphocyte activation. By blocking CTLA-4, ipilimumab enhances immune responses against tumor cells, but also exposes normal tissues to an increased risk of autoimmune phenomena as a potential side effect. In this report, we describe the case of a 58-year-old woman with metastatic melanoma who was treated with ipilimumab in the weeks prior to the onset of severe nonresolving dyspnea and cough. Extensive workup revealed organizing pneumonia as the cause of her hypoxemic respiratory failure and treatment with steroids led to a resolution of her pulmonary disease. To our knowledge, this is the first report of pulmonary toxicity caused by ipilimumab, which manifested on pathology as organizing pneumonia.

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