{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T12:32:43Z","timestamp":1769344363756,"version":"3.49.0"},"reference-count":18,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,5,16]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>Immune checkpoint inhibitors (ICIs) improve significantly outcome of patients with advanced renal cancer. Although immune-related adverse events involve frequently skin, digestive tract, lung, liver and endocrine organs, haematological toxicities are rare. We describe the case of a patient with metastatic renal cancer who was treated with nivolumab. Eight courses of nivolumab were administered without any toxicity; brain metastases were then diagnosed and treated with stereotactic radiotherapy. As the extra-cranial disease was stable, the ninth course of nivolumab was administered 5 days after the end of radiotherapy. One week later, he presented with rectal and nasal bleeding in a context of severe thrombocytopenia (1000\/mm<jats:sup>3<\/jats:sup>). High dose of steroids and intravenous immunoglobulin reversed slowly the thrombocytopenia. This case highlights the possibility of life-threatening thrombocytopenia with ICIs. Interestingly, the close time relation with radiotherapy highlights a potential interaction, warranting a close follow-up of patients in this situation.<\/jats:p>","DOI":"10.1136\/bcr-2020-235249","type":"journal-article","created":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T06:09:32Z","timestamp":1591769372000},"page":"e235249","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Rare case of life-threatening thrombocytopenia occurring after radiotherapy in a patient treated with immune checkpoint inhibitor"],"prefix":"10.1136","volume":"13","author":[{"given":"Aurore","family":"Hendrix","sequence":"first","affiliation":[{"name":"Medical Oncology, Hopital de Jolimont, Haine Saint Paul, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Emmanuella","family":"Yeo","sequence":"additional","affiliation":[{"name":"Medical Oncology, Hopital de Jolimont, Haine Saint Paul, 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