Search

Immunotherapy has advanced the treatment of solid organ malignancies. Although generally well tolerated, treatment with immune checkpoint inhibitors can be complicated by immune-related adverse events, some of which are relatively uncommon. We report the first case of gingival linear immunoglobulin A disease related to treatment with an antiprogrammed cell death protein 1 antibody. A 73-year-old male with advanced non–small cell lung cancer achieved a durable response to nivolumab monotherapy. After 1 year of treatment, he developed gingival swelling and pain. Biopsy revealed linear immunoglobulin A disease of the gingiva which was effectively treated with systemic steroids. Ongoing vigilance for immune-mediated toxicity is paramount during and after treatment with immune checkpoint inhibitors.

The safety and efficacy of temporary pericardial pacing wires have been accepted and their use is common after cardiac operations. Complications related to pacing wire removal are unusual but it can be serious and even catastrophic. We report an unusual case of bleeding due the laceration and rent created in the saphenous vein graft wall by the metallic tip of the pacing wire at the time of pacing wire removal.