{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T16:17:37Z","timestamp":1761581857664,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,8,3]],"date-time":"2019-08-03T00:00:00Z","timestamp":1564790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pazopanib, a tyrosine kinase inhibitor, and nivolumab, an immune checkpoint inhibitor, are both considered to cause hepatotoxicity with different pathophysiology. We report a case in which a patient died of severe hepatotoxicity who was presumed to have been caused by the administration of nivolumab followed by pazopanib for metastatic renal cell carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 74\u2010year\u2010old male with metastatic renal cell carcinoma was treated with nivolumab as a third\u2010line treatment. However, nivolumab was subsequently discontinued, as it caused severe thyroiditis. About 2\u00a0months after the final dose of nivolumab was administered, pazopanib was initiated as a fourth\u2010line treatment. The patient suffered from lethal hepatic failure and died 18\u00a0days after the initiation of pazopanib treatment. An autopsy revealed that CD8\u2010positive lymphocytes had infiltrated the thyroid gland and liver.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The patient was considered to have died of severe hepatic failure due to the aggravation of mild nivolumab\u2010induced immune\u2010related hepatitis by pazopanib.<\/jats:p><\/jats:sec>","DOI":"10.1002\/iju5.12101","type":"journal-article","created":{"date-parts":[[2019,8,3]],"date-time":"2019-08-03T07:40:23Z","timestamp":1564818023000},"page":"272-275","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Delayed nivolumab\u2010induced hepatotoxicity during pazopanib treatment for metastatic renal cell carcinoma: An autopsy case"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5203-493X","authenticated-orcid":false,"given":"Maki","family":"Todo","sequence":"first","affiliation":[{"name":"Department of Pharmacy Saitama Medical University International Medical Center Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5867-891X","authenticated-orcid":false,"given":"Hideyuki","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taiki","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsukasa","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Okabe","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1796-7301","authenticated-orcid":false,"given":"Go","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masafumi","family":"Oyama","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suguru","family":"Shirotake","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koshiro","family":"Nishimoto","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3239"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1510665"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0160221"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-018-0013-y"},{"key":"e_1_2_8_6_1","first-page":"1471839","article-title":"Clinical impact of consolidative and salvage radiotherapy for lymph node metastasis in upper urinary tract urothelial carcinoma","volume":"2018","author":"Kondo H","year":"2018","journal-title":"Case Rep. 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