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CASE REPORT
Year : 2021  |  Volume : 11  |  Issue : 2  |  Page : 95-97

Cryoglobulinemia unmasked by nivolumab in a patient with hepatitis C-induced hepatocellular carcinoma: A case report and literature review


1 Department of Medical Education, Saint Michael's Medical Centre, New York Medical College, Newark, New Jersey, USA
2 Department of Medical Education; Department of Internal Medicine; Department of Hematology/Oncology, Saint Michael's Medical Centre, New York Medical College, Newark, New Jersey, USA

Correspondence Address:
Dr. Amr Ramahi
Department of Medical Education, Saint Michael's Medical Centre, New York Medical College, Newark, New Jersey 07102
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJCIIS.IJCIIS_11_20

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Hepatocellular carcinoma (HCC) is ranked the fifth-most common cancer in men and ninth most common cancer in women. Immunotherapy has been shown effective in malignancies refractory to chemotherapy and has been used as a second-line therapies in many advanced cancers, including HCC. The advent of immunotherapy has resulted in a brand-new set of side effects, and it has been proposed that it was related to over activated immune system. Herein, we presented the case of 59-year-old African American gentlemen who was diagnosed with HCC caused by Hepatitis C virus, for which he was started on chemotherapy and immunotherapy. However, the patient developed cryoglobulinemia that prompted stopping both therapies and giving rituximab and steroids. We believe that the mixed cryoglobulinemia was unmasked by immunotherapy in our patient. To our knowledge, this is one of the few first cases to describe such adverse effect from immune checkpoint inhibitors.


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