{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:21:54Z","timestamp":1780514514675,"version":"3.54.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors (ICIs) improve cancer outcomes but may cause immune-related adverse events (irAEs). Nivolumab, an anti-PD-1 agent, is associated with hepatotoxicity and gastrointestinal toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 33-year-old American male with anaplastic large cell lymphoma of the lung, maintained on nivolumab monotherapy for five years, presented in late 2024 with fever (102.8\u00b0F), tachycardia (130\u00a0bpm), fatigue, nausea, vomiting, and abdominal discomfort. Laboratory tests revealed mild transaminitis; infectious workup was negative. CT imaging showed mild hepatic steatosis, distal ileitis, and mesenteric lymphadenopathy. Suspected nivolumab toxicity led to permanent discontinuation of therapy and initiation of high-dose corticosteroids, resulting in rapid improvement. He was discharged on day four with a steroid taper and TMP-SMX prophylaxis but was lost to follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case emphasizes the potential for delayed nivolumab-induced hepatotoxicity and ileitis, underscoring the importance of early recognition and prompt management of late-onset irAEs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/omcr\/omag053","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T12:28:52Z","timestamp":1773664132000},"source":"Crossref","is-referenced-by-count":1,"title":["Immune checkpoint inhibitor-associated hepatotoxicity and ileitis: a diagnostic challenge in a patient on long-term nivolumab therapy"],"prefix":"10.1093","volume":"2026","author":[{"given":"Farah","family":"Shahzad","sequence":"first","affiliation":[{"name":"Department of Medicine, Khyber Medical College , Rd No. 2, Rahat Abad, Peshawar 25120 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Shahzad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Foundation University Medical College , Defence Ave, Islamabad 44000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Tariq","sequence":"additional","affiliation":[{"name":"Department of Medicine, Aziz Fatimah Medical and Dental College , Canal Expy, Faisalabad 38000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mushayyada","family":"Fatima","sequence":"additional","affiliation":[{"name":"Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital , Phase 5, Peshawar 25000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2085-8739","authenticated-orcid":false,"given":"Pawan Kumar","family":"Thada","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sotang Primary Hospital , Solukhumbu 56000 ,","place":["Nepal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Uzair Khan","family":"Niazi","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Foundation University Medical College , Defence Ave, Islamabad 44000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Wahab","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fauji Foundation Hospital , Jhelum road, Rawalpindi 46000 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman","family":"Shahzad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Parkview Regional Medical Center , Fort Wayne, IN 46845 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"key":"2026051007063770700_ref1","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1056\/NEJMra1703481","article-title":"Immune-related adverse events associated with immune checkpoint blockade","volume":"378","author":"Postow","year":"2018","journal-title":"N Engl J Med"},{"key":"2026051007063770700_ref2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.intimp.2018.06.001","article-title":"Immune checkpoint blockade therapy for cancer: an overview of FDA-approved immune checkpoint inhibitors","volume":"62","author":"Hargadon","year":"2018","journal-title":"Int Immunopharmacol"},{"key":"2026051007063770700_ref3","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/j.alit.2022.01.001","article-title":"Immune-related adverse 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