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JAMA Oncology Clinical Challenge
August 19, 2021

Anuric Kidney Failure in a Patient With Metastatic Melanoma

Author Affiliations
  • 1The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
  • 2Laura and Isaac Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, New York
JAMA Oncol. 2021;7(10):1567-1568. doi:10.1001/jamaoncol.2021.3515

A 53-year-old man received a diagnosis of stage IV melanoma with metastatic disease to the spine and brain 3 months before presentation. Four weeks following receipt of immunotherapy with ipilimumab and nivolumab, he developed acute abdominal pain in the setting of a rapidly rising lactic acid dehydrogenase levels, prompting hospital admission. Imaging results showed mild disease progression (new ascites and periportal metabolic lymph node). Splenic infarct and portal/splenic vein thrombi were identified as etiologies of his acute pain and were presumed to be secondary to hypercoagulable state of malignancy.

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