Neurotoxicity: A Rare Side Effect of Programmed Cell Death 1 (PD-1) Inhibitors.

Immunotherapy is a biological therapy that helps the body's immune system to fight against cancer cells. The Food and Drug Administration (FDA) approved the first immune checkpoint inhibitor in 2011. Since 2011, many immune checkpoint inhibitors have been approved. Programmed cell death 1 (PD-1) inhibitors are now commonly used in multiple malignancies due to their remarkable response. Thus, immune-related adverse events are now coming into the limelight due to the increasing use of PD-1 inhibitors. Here, we present a case of a 54-year-old female with non-small cell lung cancers (NSCLC) treated with pembrolizumab and later presented with severe neurotoxicity.

Renal Mucosa-Associated Lymphoid Tissue (MALT) Associated End-Stage Renal Disease in a Patient Presenting With Diarrhea.

Extranodal marginal zone lymphoma (MZL) of mucosa-associated lymphoid tissue (MALT) is most commonly found in the GI tract. Other less common anatomical sites for MALT include the skin, intestine, salivary glands, lungs, and ocular adnexa. Isolated MALT of the kidney has only been sporadically reported. Most of the reported cases in the literature present with underlying renal mass and are generally diagnosed post nephrectomy. We present a case of a 73-year-old gentleman with biopsy-proven primary MALT of the kidney who presented with acute kidney injury (AKI) in the background of Clostridium difficile (C. difficile) colitis. However, our patient did not have a renal mass a renal biopsy was performed due to accelerated deterioration of renal function. Due to the inherent heterogeneity of the disease, it is challenging to have a unifying treatment strategy for MALT with treatment varying with the anatomical site. We also discuss current and prospective treatment strategies for MALT and marginal zone lymphoma in general.

A Case of Intermittent Left Bundle Branch Block.

An 82-year-old woman with uncontrolled hypertension and occasional exertional dyspnea was found to be in intermittent left bundle branch block (LBBB). Her laboratory results, echocardiogram, and ischemic workup were unremarkable. This case highlights that intermittent LBBB is not always associated with coronary ischemia, vasospasm, blunt cardiac injury, drugs, and high catecholaminergic or inflammatory states.