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Aim: Immune checkpoint inhibitors have transformed cancer treatment; however, clinical trials often exclude patients with renal dysfunction. This study aimed to evaluate the efficacy and safety of nivolumab in this population, addressing the limited available data. Methods: A retrospective cross-sectional study was conducted on patients with baseline renal dysfunction who received nivolumab between 2018 and 2023. The safety and efficacy endpoints, including immune-related adverse events (irAEs), treatment response, and progression-free survival. Results: Fifty patients with various malignancies were included, with 30% experiencing manageable worsening of renal function. Approximately 51% of patients experienced no irAEs, whereas 8% experienced grade 3 or 4 adverse events. The treatment discontinuation rate due to adverse effects was 2%. Significantly, 68% of patients showed treatment benefits, with a median progression-free survival of 450 days. Conclusion: Nivolumab is effective and safe for patients with renal dysfunction, with comparable outcomes to those without renal impairment. Despite the occurrence of IrAEs, they were manageable, and we observed benefits in long-term progression-free survival.

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory disease of the central nervous system (CNS) and is commonly seen in children. It has seasonal peaks in winter and spring, consistent with its infectious etiologies, and it rarely occurs as a reaction to vaccination. ADEM is less common in adults and progresses with a more severe clinical course. Cases diagnosed with ADEM by CNS demyelination after streptococcal meningitis have rarely been reported in adult patients. In this report, we present a rare case of a 31-year-old female diagnosed with ADEM following pneumococcal meningitis treatment and treated successfully with low-dose methylprednisolone.

A 36-year-old male patient, who was an agricultural farmer and had a diagnosis of bicuspid aortic valve and coarctation, was admitted with symptoms of fever, fatigue, and shortness of breath that lasted for a month, in March 2017. Examination revealed dyspnea and bilateral rales and rhonchi in lung auscultation. A 3/6 systolic murmur was heard in the mesocardiac focus. The laboratory tests showed a white blood cell count of 15.14×103/µl, erythrocyte sedimentation rate of 36 mm/h, and C-reactive protein of 26 mg/l. An echocardiogram showed mobile vegetation (30×10 mm) on the aortic valve and severe aortic and tricuspid valve insufficiency. All blood cultures that are taken from the patient with the diagnosis of infective endocarditis were negative and C. burnetii phase I IgG antibody was positive at 1/32768 titer. As far as we know, herein, we present a case of endocarditis due to C. burnetii, which is the third case that is reported in Turkey.

Mastitis is a generalized cellulitis condition of breast tissue usually seen in female patients between 18-50 years of age. Granulomatous mastitis (GM), which is one of the rare types, is usually an idiopathic disease and can be caused by infectious microorganisms. In this report, a 35-year-old female patient diagnosed as having GM infected with Corynebacterium amycolatum was reported and the relevant literature was reviewed. The patient was treated with a combination of amoxicillin/clavulanic acid and clindamycin and no recurrence was observed at 10 months follow-up.

Although mild liver involvement is common in patients with Epstein-Barr virus (EBV) infection-induced infectious mononucleosis, acute cholestatic hepatitis is rare. In this report, we describe a 21-year-old previously healthy man with EBV-induced infectious mononucleosis presenting with acute cholestatic hepatitis. Serological tests for EBV infection were consistent with acute infection (EBV capsid antigen was reactive with IgM and IgG antibodies) and the Monospot test was positive. The patient was managed supportively and his condition improved. Acute EBV infection should be considered in the differential diagnosis of patients presenting with cholestatic hepatitis.