{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:06:14Z","timestamp":1763661974286,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,12,31]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>Immune checkpoint inhibitors (ICIs) are increasingly used to treat certain malignancies due to their higher efficacy compared with conventional chemotherapy. As familiarity with these agents increases, it is becoming apparent that a significant number of patients treated with ICIs experience adverse events. With time, more immune-related adverse events (IRAEs) are being recognised. It is important to be vigilant for IRAEs and recognise that a patient may have multiple IRAEs affecting multiple organ systems. Common cardiovascular adverse events associated with ICIs include myocarditis, arrhythmias and pericarditis. This case report identifies a patient presenting with takotsubo syndrome followed by ketoacidosis (associated with sodium-glucose transport protein 2 (SGLT2) inhibitor) in the setting of combination ipilimumab and nivolumab therapy for metastatic melanoma.<\/jats:p>","DOI":"10.1136\/bcr-2020-237217","type":"journal-article","created":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T16:30:35Z","timestamp":1612197035000},"page":"e237217","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Immune checkpoint inhibitor-induced takotsubo syndrome and diabetic ketoacidosis: rare reactions"],"prefix":"10.1136","volume":"14","author":[{"given":"Kieran","family":"Oldfield","sequence":"first","affiliation":[{"name":"Department of Medicine, Gold Coast University Hospital, Southport, QLD, Australia"},{"name":"School of Medicine, Griffith University, Gold Coast, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan","family":"Jayasinghe","sequence":"additional","affiliation":[{"name":"School of Medicine, Griffith University, Gold Coast, QLD, Australia"},{"name":"Department of Cardiology, Gold Coast University Hospital, Southport, QLD, Australia"},{"name":"School of Medicine, Bond University, Gold Coast, QLD, Australia"},{"name":"School of Medicine, Macquarie University, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selvanayagam","family":"Niranjan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Gold Coast University Hospital, Southport, QLD, Australia"},{"name":"School of Medicine, Griffith University, Gold Coast, QLD, Australia"},{"name":"School of Medicine, Bond University, Gold Coast, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Chadha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Maimonides Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"key":"2025082708164687000_14.2.e237217.1","doi-asserted-by":"publisher","DOI":"10.1038\/s12276-018-0116-z"},{"key":"2025082708164687000_14.2.e237217.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2015.11.016"},{"key":"2025082708164687000_14.2.e237217.3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3389\/fcvm.2019.00003","article-title":"Cardiac complications in immune checkpoint inhibition therapy","volume":"6","author":"Tajiri","year":"2019","journal-title":"Front Cardiovasc Med"},{"key":"2025082708164687000_14.2.e237217.4","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.currproblcancer.2018.07.002","article-title":"Cardiotoxicities associated with immune checkpoint inhibitors","volume":"42","author":"Yang","year":"2018","journal-title":"Curr Probl Cancer"},{"key":"2025082708164687000_14.2.e237217.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.07.079"},{"key":"2025082708164687000_14.2.e237217.6","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1002\/ejhf.1497","article-title":"Takotsubo syndrome in patients with cancer treated with immune checkpoint inhibitors: a new adverse cardiac complication","volume":"21","author":"Ederhy","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2025082708164687000_14.2.e237217.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.11.036"},{"key":"2025082708164687000_14.2.e237217.8","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-015-0048-2"},{"key":"2025082708164687000_14.2.e237217.9","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-019-0754-2"},{"key":"2025082708164687000_14.2.e237217.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.01.016"},{"key":"2025082708164687000_14.2.e237217.11","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl032"},{"key":"2025082708164687000_14.2.e237217.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.06.016"},{"key":"2025082708164687000_14.2.e237217.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.02.029"},{"key":"2025082708164687000_14.2.e237217.14","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2017-000247"},{"key":"2025082708164687000_14.2.e237217.15","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfp008"},{"key":"2025082708164687000_14.2.e237217.16","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14050"},{"key":"2025082708164687000_14.2.e237217.17","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1530\/EJE-19-0291","article-title":"Immune checkpoint inhibitors and type 1 diabetes mellitus: a case report and systematic review","volume":"181","author":"de Filette","year":"2019","journal-title":"Eur J Endocrinol"},{"key":"2025082708164687000_14.2.e237217.18","doi-asserted-by":"publisher","DOI":"10.2337\/db18-1471-P"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-237217","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:16:54Z","timestamp":1756307814000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-237217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":18,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,1]]},"published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1136\/bcr-2020-237217"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-237217","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}