{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T14:56:44Z","timestamp":1778511404958,"version":"3.51.4"},"reference-count":13,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,2,1]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>Nivolumab is a programmed death-1 receptor blocker within the family of medications called immune checkpoint inhibitors (ICIs). Although generally well tolerated, cases of immune\u2010related adverse events (irAEs) have been reported. We present a case of a man being treated with nivolumab for renal cell carcinoma who presented to the emergency department with problems of headache, fever and disorientation. After extensive evaluation, a diagnosis of immunotherapy-induced aseptic meningitis was considered more probable than infectious. Due to stable clinical status, no treatment was initiated, and the patient\u2019s condition improved spontaneously. The patient was discharged home. To date, only a handful of prior cases of nivolumab-induced meningitis have been reported. Our case demonstrates that irAEs can occur years after the initiation of ICIs. This was a milder presentation of a neurological irAE that resolved spontaneously with watchful waiting, showing that irAEs are likely an evolving spectrum of disease for which clinicians should be aware.<\/jats:p>","DOI":"10.1136\/bcr-2023-258141","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T07:55:23Z","timestamp":1708156523000},"page":"e258141","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Long-term nivolumab treatment possibly associated with aseptic meningitis."],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2129-4760","authenticated-orcid":false,"given":"Wasef","family":"Al-Khateeb","sequence":"first","affiliation":[{"name":"College of Medicine, Department of Internal Medicine, Central Michigan University, Saginaw, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Jarad","sequence":"additional","affiliation":[{"name":"College of Medicine, Department of Internal Medicine, Central Michigan University, Saginaw, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri","family":"Kim","sequence":"additional","affiliation":[{"name":"College of Medicine, Department of Internal Medicine, Central Michigan University, Saginaw, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Battisti","sequence":"additional","affiliation":[{"name":"College of Medicine, Department of Internal Medicine, Central Michigan University, Saginaw, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"key":"2025082711191278000_17.2.e258141.1","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1080\/14740338.2020.1738382","article-title":"Neurologic complications of immune checkpoint inhibitors","volume":"19","author":"Haugh","year":"2020","journal-title":"Expert Opin Drug Saf"},{"key":"2025082711191278000_17.2.e258141.2","unstructured":"National Cancer Institute . Nivolumab. Bethesda:National Cancer Institute; 2015. Available: https:\/\/www.cancer.gov\/about-cancer\/treatment\/drugs\/nivolumab"},{"key":"2025082711191278000_17.2.e258141.3","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s11060-020-03687-2","article-title":"Neuroimmunological adverse events associated with immune checkpoint inhibitor: a retrospective, pharmacovigilance study using FAERS database","volume":"152","author":"Mikami","year":"2021","journal-title":"J Neurooncol"},{"key":"2025082711191278000_17.2.e258141.4","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2016-0487"},{"key":"2025082711191278000_17.2.e258141.5","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"2025082711191278000_17.2.e258141.6","doi-asserted-by":"crossref","first-page":"722586","DOI":"10.3389\/fendo.2021.722586","article-title":"Case report: a variety of immune-related adverse events triggered by immune checkpoint inhibitors in a subject with malignant melanoma: destructive thyroiditis","volume":"12","author":"Katakura","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2025082711191278000_17.2.e258141.7","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-021-03695-w"},{"key":"2025082711191278000_17.2.e258141.8","first-page":"590","article-title":"Relapse of aseptic meningitis induced by ipilimumab and nivolumab therapy for metastatic renal cell carcinoma: a case report","volume":"11","author":"Takamatsu","year":"2019","journal-title":"Mol Clin Onc"},{"key":"2025082711191278000_17.2.e258141.9","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1002\/ccr3.2534","article-title":"Neurotoxicities associated with checkpoint inhibitors: two case reports and a review of the literature","volume":"8","author":"Cordes","year":"2020","journal-title":"Clin Case Rep"},{"key":"2025082711191278000_17.2.e258141.10","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1620\/tjem.2022.J071","article-title":"Cerebrospinal fluid Interleukin-6 in immune checkpoint inhibitor-induced autoimmune meningoencephalitis","volume":"258","author":"Mizukami","year":"2022","journal-title":"Tohoku J Exp Med"},{"key":"2025082711191278000_17.2.e258141.11","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1159\/000513001","article-title":"Immune-related meningoencephalitis following nivolumab in metastatic renal cell carcinoma","volume":"14","author":"Shields","year":"2021","journal-title":"Case Rep Oncol"},{"key":"2025082711191278000_17.2.e258141.12","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1177\/10781552221118529","article-title":"Nivolumab-Ipilimumab combination therapy-induced seronegative encephalitis; rapid response to steroid plus intravenous immunoglobulin (IVIG) treatment","volume":"29","author":"Bir Yucel","year":"2023","journal-title":"J Oncol Pharm Pract"},{"key":"2025082711191278000_17.2.e258141.13","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.ejca.2017.05.036","article-title":"Safety of treatment with nivolumab after ipilimumab-related meningoradiculitis and bilateral optic neuropathy","volume":"83","author":"Boisseau","year":"2017","journal-title":"Eur J Cancer"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258141","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:19:21Z","timestamp":1756318761000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,17]]},"published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1136\/bcr-2023-258141"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258141","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}