You are here

Article Text

Article menu
Download PDFPDF
Case report
Durvalumab-associated vasculitis presenting as ‘the blue toe syndrome’
  1. Shivangi Gupta1,
  2. Dan Xu2,3,
  3. Jane Hadfield4 and
  4. David Prentice4
  1. 1Curtin Medical School, Faculty of Health Sciences, Curtin University Bentley Campus, Perth, Western Australia, Australia
  2. 2Curtin Medical School/School of Public Health, Faculty of Health Sciences, Curtin University Bentley Campus, Perth, Western Australia, Australia
  3. 3Medical Education, The First Affiliated Hospital, Sun Yan-Sen University, Guangzhou, China
  4. 4Internal Medicine, St John of Gods Hospital Midland, Perth, Western Australia, Australia
  1. Correspondence to Professor Dan Xu; daniel.xu{at}curtin.edu.au

Abstract

Durvalumab is a selective, high-affinity human immunoglobulin monoclonal antibody in a class called check point inhibitors, that blocks PD-L1 on tumour cells. Despite clinical success in increasing progression-free survival rates in patients with stage III non-small-cell lung cancer, durvalumab has been associated with immune-related side effects such as pneumonitis and colitis. We present a case of an 84-year-old woman with acral vasculitis presenting as blue toe syndrome, associated with prolonged use of durvalumab. After 1 year of fortnightly durvalumab therapy postchemoradiation therapy, the patient came in with a left blue big toe, and later developed bilateral livedo racemosa. The diagnosis of durvalumab-associated vasculitis was made and treatment with prednisolone was started with clinical improvement.

  • immunological products and vaccines
  • drugs and medicines
  • cancer intervention
  • vasculitis
  • respiratory system

http://dx.doi.org/10.1136/bcr-2020-235886

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors SG is the first author designing, initially drafting and reviewing the manuscript. DX is the corresponding author editing and reviewing the manuscript. JH is the senior author designing, editing and critically reviewing the manuscript. DP is the senior and cocorresponding author designing, editing and critically reviewing the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.