{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:56:19Z","timestamp":1791446179270,"version":"4.3.3"},"reference-count":11,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Cytokine release syndrome (CRS) induced by immune checkpoint inhibitors (ICIs) is a potentially life\u2010threatening immune\u2010related adverse event (irAE). CRS has been recognized as a complication of chimeric antigen receptor T\u2010cell (CAR\u2010T) therapy and bispecific T\u2010cell engager (BiTE) therapy, but remains exceedingly rare as a complication of ICI therapy. Here, we report a case of CRS that developed after combination therapy with nivolumab and ipilimumab in a woman in her 60s with advanced conjunctival melanoma. The diagnosis was based on the clinical course and imaging findings together with characteristic laboratory abnormalities, including systemic inflammation, hepatic dysfunction, coagulopathy, and marked hyperferritinemia. This case highlights the importance of careful exclusion of infectious and neoplastic diseases for early diagnosis, demonstrates that ICI\u2010related CRS can relapse after initial control, and shows that it may overlap with hemophagocytic lymphohistiocytosis (HLH)\u2013like syndromes. Given the central role of interleukin\u20106 (IL\u20106) in CRS, early administration of tocilizumab may contribute to rapid control of inflammation and reduction of steroid exposure.<\/jats:p>","DOI":"10.1111\/1346-8138.70413","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:01:48Z","timestamp":1784865708000},"page":"1537-1541","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cytokine Release Syndrome Induced by Combination Therapy With Nivolumab and Ipilimumab in Lower Palpebral Conjunctival Melanoma: A Case Report"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7535-2599","authenticated-orcid":false,"given":"Kaito","family":"Suzuki","sequence":"first","affiliation":[{"name":"Department of Dermato\u2010Oncology The Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiro","family":"Uehara","sequence":"additional","affiliation":[{"name":"Department of Dermato\u2010Oncology The Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7545-4101","authenticated-orcid":false,"given":"Koichi","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Onco\u2010Rheumatology The Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9939-370X","authenticated-orcid":false,"given":"Shoichiro","family":"Ishizuki","sequence":"additional","affiliation":[{"name":"Department of Dermato\u2010Oncology The Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayumi","family":"Aoki","sequence":"additional","affiliation":[{"name":"Department of Dermato\u2010Oncology The Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9844-5404","authenticated-orcid":false,"given":"Ryugo","family":"Sekiyama","sequence":"additional","affiliation":[{"name":"Department of Dermato\u2010Oncology The Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Akiya","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology The Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Yoshino","sequence":"additional","affiliation":[{"name":"Department of Dermato\u2010Oncology The Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(24)00185-1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2022.07.001"},{"key":"e_1_2_7_4_1","unstructured":"A.Slota R.Khan A.Rahman andE.Warner \u201cCytokine Release Syndrome as a Rare Complication of Nivolumab \u201dAbstract presented at Hospital Medicine 2020 Virtual Competition Society of Hospital Medicine Abstract 1133 (2021)."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000525173"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/crh\/5444075"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1190379"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.807050"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-017-0311-9"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2019.07.014"},{"key":"e_1_2_7_11_1","unstructured":"National Comprehensive Cancer Network \u201cManagement of Immune Checkpoint Inhibitor\u2013Related Toxicities. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) \u201d(2021)."},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2022.04.004"}],"container-title":["The Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.70413","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1346-8138.70413","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.70413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:35:18Z","timestamp":1791444918000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1346-8138.70413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":11,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/1346-8138.70413"],"URL":"https:\/\/doi.org\/10.1111\/1346-8138.70413","archive":["Portico"],"relation":{},"ISSN":["0385-2407","1346-8138"],"issn-type":[{"value":"0385-2407","type":"print"},{"value":"1346-8138","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]},"assertion":[{"value":"2026-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}