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Pyrogenic lower limbs
  1. Eurydice Angeli1,2,3,
  2. Alexander Ariel Padrón González1,
  3. Diaddin Hamdan1,4,
  4. Gabriel Pop5,
  5. Géraldine Falgarone1,3,6,
  6. Guilhem Bousquet1,2,3
  1. 1INSERM, UMR_S942 MASCOT, F-75006, Paris, France
  2. 2AP-HP, Hôpital Avicenne, Oncologie médicale, F-93000, Bobigny, France
  3. 3Unviersité Sorbonne Paris Nord, F-93017, Bobigny, France
  4. 4Hôpital La Porte Verte, F-78000, Versailles, France
  5. 5Département de médecine nucléaire, hôpital Avicenne, AP-HP, F-93009, Bobigny, France
  6. 6Unité de Médecine Ambulatoire (UMA), hôpital Avicenne, AP-HP, F-93009, Bobigny, France
  1. Correspondence to Professor Géraldine Falgarone, AP-HP, Unité de Médecine Ambulatoire (UMA), hôpital Avicenne, F-93009, Bobigny, Île-de-France, France; g.falgarone{at}

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In 2020, a 45-year-old woman underwent a right nephrectomy for a localised clear-cell renal cell carcinoma. A year later, she experienced a febrile metastatic relapse with a large 15 cm thoracic para-aortic mass and a pleural effusion. An exhaustive investigation concluded to a febrile state linked to tumour progression. The patient was treated with a combination of nivolumab (anti PD-1; 3 mg/kg every 3 weeks) and ipilimumab (anti CTLA-4; 1 mg/kg every 3 weeks) associated with oral prednisone at 20 mg/day to treat the fever. After 3 months of treatment, she experienced a good clinical response, and the fever disappeared. Partial response was observed on CT imaging, after which prednisone was discontinued.

One month later, the fever reappeared, associated with …

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  • Handling editor Josef S Smolen

  • Twitter @FalgaGe

  • Contributors Planning: EA, GF and GB. Conducting: EA, AAPG, DH, GP, GF and GB. Reporting: EA, GF and GB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.