Medical Specialties Commons^™

Complete Dorsal Pancreatic Agenesis: A Case Report, Ritish Gupta, Ashima Mittal, Bhavna Arora, Riya Aggarwal

Journal of Medicine in Scientific Research

Complete agenesis of the dorsal pancreas (ADP), an extremely rare congenital anomaly, is caused as ‘the dorsal pancreatic bud fails in developing the body and tail of the pancreas at the time of embryological development.’ There are nearly 100 cases of dorsal pancreatic agenesis till date. Most of the individuals with ADP are without symptoms; however, few may present with clinical manifestations like pancreatitis, epigastric pain, hyperglycemia, and diabetes mellitus. This is a case report of a 19-year-old female with ADP, who was diagnosed incidentally while undergoing radiological assessment for abdominal pain in left hypochondrium. As complete ADP is very …

Prevalence Of Upper Limb Musculoskeletal Abnormalities In Type 2 Diabetic Patients And Its Relation To Glycemic Control And Associated Factors, Eslam Elsayed Ali Shohda, Amal Emam El-Maghraby, Hadeer Khaled Youssef Elhamid

Journal of Medicine in Scientific Research

Aim of the study: to investigate the prevalence of upper limb musculoskeletal abnormalities and their correlations to glycemic control and associated factors. Methods: A cross-sectional study was conducted at diabetes unit and internal medicine outpatient clinic at Al-ahrar teaching hospital, Zagazig, Egypt. 200 type 2 diabetic patient (T2DM) and 200 non-diabetic control patients of ages > 18 years were enrolled. Rheumatological diseases were excluded. Studied upper limb musculoskeletal abnormalities were Limited joint mobility (LJM), Dupuytren’s contracture (DC), Trigger finger (TF), De Quervain’s tenosynovitis (DQT), Lateral epicondylitis (LE), Medial epicondylitis (ME), Rotator’s cuff tendinitis (RCT) and Carpel tunnel syndrome susceptibility diagnosed by …

Assessment Of Carotid Intima-Media Thickness And Its Relation To Cardiovascular Risk Factors In Obese Children, Faten A.A. Fathi, Somaya M. Abd El Ghany, Ahmed A.H. Taha, Gihan F.A. Hassan, Eman Fouad

Journal of Medicine in Scientific Research

Background Childhood obesity is one of the most critical public health problems today. This study aims to assess the relation between carotid intima-media thickness (CIMT) and cardiovascular risk factors in obese children. Patients and methods This is a case–control study conducted on 80 Egyptian children aged 6–18 years; 40 children with simple obesity as defined by WHO (2011) and 40 healthy children age matched and sex matched were taken as a control group. Cases were selected from the National Nutritional Institute randomly from December 2017 to March 2018. All patients and control groups were subjected to the following: full history …

Outcome Of A Case Of Living Donor Kidney Transplant With High Levels Of Pre-Transplant Donor Specific Antibodies, Ahmed Hassan Elthakaby, Aza Elmenyawi

Journal of Medicine in Scientific Research

For patients with ESRD, kidney transplant offers significant survival and quality-of-life advantages compared with dialysis. Non-sensitized renal transplant recipients when compared to patients with preformed alloantibodies, the latter are at greater risk of cellular, humeral rejection and premature graft failure. In this paper we will present a successful case of young adult who has ESRD and maintained on regular hemodialysis and undergo live related renal transplant with high dose HLA class I and class II antibodies and negative cross match by CDC and flow cytometry.

Oral Mucosal And Dental Affection In Patients With Systemic Lupus Erythematosus: A Clinical Survey, Omnia A Abubakr, Ali M Youssef, Mohamed A Mohamed, Mohamed A Hamdy

Journal of Medicine in Scientific Research

Background: SLE is a chronic autoimmune disease predominantly affecting young females. Systemic involvement along with variable clinical presentations characterizes SLE. Various oral and dental manifestations have been described in SLE that include oral ulcerations, candida infection, and periodontal disease. We aimed to detect oral mucosal and dental disease in SLE patients and its relation to demographic features, general disease activity, and the extra-articular manifestation. Patients and Methods: 80 patients with SLE were included in this cross-sectional study. Patients were allocated into 2 groups, 40 patients in each group, according to SLE disease control with immunosuppressive medications: group A included patients …

Repair Vs. Conservative Treatment For Ischemic Patients With A Moderate Degree Of Mitral Incompetence, Ahmed Shafeek Ali, Mohamed Belal Mohamed Abd Elbaki, Haitham Alshahat Ramadan, Reham Mohammed Salah Eldin Ahmed

Journal of Medicine in Scientific Research

Background: Ischemic heart diseases are often associated with a moderate degree of mitral incompetence. The optimal treatment of this condition is still controversial. benefits of repairing moderate mitral incompetence in ischemic patients are uncertain. Objectives: compare outcomes of treating ischemic patients with moderate mitral incompetence either by isolated CABG versus CABG with mitral repair. Patients and methods: We prospectively studied 60 consecutive ischemic patients with a moderate degree of mitral incompetence who were surgically treated at the National Heart Institute between the period of April 2021 to March 2022. 30 patients had isolated CABG surgery while the other 30 patients …

Studying The Therapeutic Effect Of Umbilical Cord Stem Cell In Pneumonia Caused By Covid-19, Salama M. El- Shennawy, Abdalla Abo Hassen, Talal Ibrahim Hagag, Asherf I Zahra, Reham Salama, Mariam A. Fouad

Journal of Medicine in Scientific Research

Context: Coronavirus disease (COVID-19) with severe respiratory morbidity and mortality , rapidly spread all over the world, caused by an sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varying from mild symptoms to pulmonary fibrosis( Li Z et al.,2020). Mesenchymal stem cells (MSCs) can have a critical role, by promoting the pulmonary parenchyma regeneration and subsequently decreasing the symptoms of COVID-19 and help immune system to act against the virus (WHO, 2020).Aim: to evaluate the efficacy and safety of using stem cell in the treatment of COVID-19patients.Setting and design: We performed this case control study during the period from November 2020 …

Assessing Serum Ferritin Together With Some Inflammatory Biomarkers In Overweight And Obese Hospital Care Workers At Elgalaa Teaching Hospital And Its Correlation With Metabolic Syndrome, Sahar Mohamed Said Elbayoumi, Hanan Farouk, Heba Abdelaziz

Journal of Medicine in Scientific Research

Obesity is known to be associated with elevated levels of inflammatory markers. One of the major problems associated with morbidity and mortality. The aim of the study was to assess the posing effect of obesity on the levels of serum ferritin, total cholesterol, HDL and LDL, triglycerides, HBA1C, CRP, and Uric acid with CBC, on random well-being colleague females. Patient and methods: 100 adult female health workers were categorized into three entities according to both BMI and waist circumference, as normal, overweight, and obese. Results: increased serum ferritin as an inflammatory marker might correlate to BMI, in juniors; and might …

Efficacy Of Native T1 Mapping In Differentiation Between Viable And Non-Viable Myocardium In Chronic Ischemia, Diab Mahmoud S, Gad Azza A.H, Abdel Lattif Reda A, Mahrous Mary R

Journal of Medicine in Scientific Research

Background Myocardial ischemia may lead to reversible or irreversible myocardial insult. A precise assessment of myocardial viability (MV) is of clinical relevance to determine the recovery potential of the affected segments. Contrast enhanced cardiac magnetic resonance (CE-CMR) with late gadolinium (Gd) sequences is the gold standard method for MV assessment. Our study tasted the accuracy of segmental native T1 mapping (NT1M) imaging as a non-contrast technique for assessing MV. Methods: Forty-three patients with chronic myocardial ischemia underwent 1.5 T CMR. Imaging protocol includes cine images to assess left ventricular (LV) function, and (LGE) images to detect and estimate the extension …

Management Of Opioid Use Disorder In Primary Care, Carolyn Jeffries

Capstone Showcase

The prevalence of opioid use disorder (OUD) in the United States, and worldwide, has drastically increased in the span of 2-3 years. OUD is considered chronic condition and as such requires routine care over a lifetime. This makes OUD patients excellent candidates to be managed by primary care providers (PCPs). This article discusses the various barriers to treatment of OUD in a primary care setting as well methods and models that aim to mitigate these barriers. We will also review how to take a detailed assessment of an OUD patient, mainstays of medication assisted treatment (MAT), and management of side …

Diagnosis And Management Of Cyclic Vomiting Syndrome, Sara Read

Capstone Showcase

Cyclic vomiting syndrome (CVS) is a chronic and debilitating condition that can be encountered in a multitude of clinical settings. It is classified as a functional gastrointestinal disorder and is often misdiagnosed. Proper identification and management of this condition are crucial to patient care and quality of life. This article reviews the hypothesized etiologies, clinical presentation, and diagnosis of CVS as well as recommendations for management in a variety of settings. As an understudied and underdiagnosed condition, it is important that clinicians have a basic understanding of this disorder.

Choosing The Route Of Delivery: A Discussion Of Vaginal And Cesarean Births, Camille Green

Capstone Showcase

The percentage of cesarean deliveries in the United States has increased to a rate of 32.1%, double what the World Health Organization recommends as an ideal rate for maternal and fetal benefits. The majority of cesarean sections are performed on women who have never had the procedure before and this increases the risk for subsequent cesarean deliveries. Half of the indications for primary cesarean delivery were found to be non-reassuring fetal heart tracings and arrest of labor, both of which are subject to obstetric provider judgment and comfort level. Among these there is also an increasing incidence of elective primary …

Exploring Factors Contributing To Compassion Fatigue In Emergency Departments And Possible Interventions, Neggin Assadi

Capstone Showcase

The ED is a fast paced, busy, and unpredictable environment. Increased exposures to death, suffering, and trauma can make the ED a stressful environment and makes providers more susceptible to a phenomenon called compassion fatigue (CF), a diminished ability to feel compassion towards those they are tasked to care for. Three main contributors to CF in the ED are a poor workplace environment, workplace aggression/violence, and traumatic events. Exploring what contributes to these stressors and proposing ways to reduce them can help ED providers combat CF.

Bibliography, Maire M. Blankenship

Faculty/Staff Personal Papers

Bibliography of publications by Maire Blankenship.

The Effects Of Sex On Zebrafish Bone Metabolism, Simon Bagatto

Williams Honors College, Honors Research Projects

I investigated the effects of diet and sex on zebrafish bone metabolism. Zebrafish were subjected to either a high-calorie or low-calorie diet over a five-week period. After this diet, zebrafish scales were used to measure alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP) enzyme activity with a fluorescent substrate. The enzyme activities were markers of the osteoblasts (ALP) and the osteoclasts (TRAP). These data were compared among sex and diet of the zebrafish using a repeated measures ANOVA statistical test. I also measured the number of resorption lacunae per scale (another indicator of osteoclast activity). The results showed higher TRAP …

A Rare Case Of Covid Encephalitis In A Vaccinated Patient, Christian Pena, Hari Movva, Hector Arredondo, Alberto Pena, Erik Hinojosa, Michael Rotko, Jorge Nadal, Michelle Lopez

MEDI 9331 Scholarly Activities Clinical Years

Background and Purpose: SARS-CoV-2 infection is known to cause primarily respiratory symptoms, however, neurological disorders such as anosmia and stroke have been seen. Encephalitis is a rare complication of COVID-19 with a reported incidence of less than 1%¹. Most patients develop both COVID-19 symptoms and encephalitis symptoms during the same period¹. In addition, the majority of reports are from patients with no prior vaccination. Here, we present a case of encephalitis 2 weeks after mild COVID-19 in a fully vaccinated male.

Case Presentation: A 68-year-old Hispanic male was brought to the ED due to new onset gaze deviation, generalized tonic …

Fatty Acid Therapy And Implications For Spinal Cord Injury Treatment: A Literature Review, Philippe J. Dentino

MEDI 9331 Scholarly Activities Clinical Years

Introduction: Spinal Cord Injuries (SCI) are catastrophic injury to spinal neurons that cause a tremendous socioeconomic and public health burden on individuals globally. The role of fatty acids in treatment of SCI is not well understood and poorly standardized across treatment provision. This review seeks to explore the role of fatty acids in neurorecovery and propose emerging themes in SCI treatment with fatty acids.

Methods: A PICO was designed and online databases were searched for relevant articles. A total of 55 studies were deemed appropriate for the review and summarized into thematic elements including ) Cellular Transport 2) Neuroprotection 3) …

Predictive Digital Twin For Optimizing Patient-Specific Radiotherapy Regimens Under Uncertainty In High-Grade Gliomas, Anirban Chaudhuri, Graham Pash, David A Hormuth, Guillermo Lorenzo, Michael Kapteyn, Chengyue Wu, Ernesto A B F Lima, Thomas E Yankeelov, Karen Willcox

Faculty, Staff and Student Publications

We develop a methodology to create data-driven predictive digital twins for optimal risk-aware clinical decision-making. We illustrate the methodology as an enabler for an anticipatory personalized treatment that accounts for uncertainties in the underlying tumor biology in high-grade gliomas, where heterogeneity in the response to standard-of-care (SOC) radiotherapy contributes to sub-optimal patient outcomes. The digital twin is initialized through prior distributions derived from population-level clinical data in the literature for a mechanistic model's parameters. Then the digital twin is personalized using Bayesian model calibration for assimilating patient-specific magnetic resonance imaging data. The calibrated digital twin is used to propose optimal …

The Short- And Long-Term Readmission Of Four Major Categories Of Digestive System Cancers: Does Obesity Or Metabolic Disorder Matter?, Yan Li, Xiaoqin Wu, Yongfeng Song, Peipei Wang, Bofei Zhang, Bingzhou Guo, Ziwei Liu, Yafei Wu, Shanshan Shao, Yiping Cheng, Honglin Guo, Xiude Fan, Jiajun Zhao

Faculty, Staff and Student Publications

Purpose: Patients with digestive system cancers (DSCs) are at a high risk for hospitalizations; however, the risk factors for readmission remain unknown. Here, we established a retrospective cohort study to assess the association between metabolic obesity phenotypes and readmission risks of DSC.

Experimental design: A total of 142,753 and 74,566 patients at index hospitalization were ultimately selected from the Nationwide Readmissions Database (NRD) 2018 to establish the 30-day and 180-day readmission cohorts, respectively. The study population was classified into four groups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). Multivariate Cox …

Receptor-Interacting Protein 1 And 3 Kinase Activity Are Required For High-Fat Diet Induced Liver Injury In Mice, Xiaoqin Wu, Rakesh K Arya, Emily Huang, Megan R Mcmullen, Laura E Nagy

Faculty, Staff and Student Publications

BACKGROUND: The RIP1-RIP3-MLKL-mediated cell death pathway is associated with progression of non-alcohol-associated fatty liver/steatohepatitis (NAFL/NASH). Previous work identified a critical role for MLKL, the key effector regulating necroptosis, but not RIP3, in mediating high fat diet-induced liver injury in mice. RIP1 and RIP3 have active N-terminus kinase domains essential for activation of MLKL and subsequent necroptosis. However, little is known regarding domain-specific roles of RIP1/RIP3 kinase in liver diseases. Here, we hypothesized that RIP1/RIP3 kinase activity are required for the development of high fat diet-induced liver injury.

METHODS:Rip1K45A/K45A and Rip3K51A/K51A kinase-dead mice on a C57BL/6J background and their littermate …

Acute Myeloid Leukemia With Concurrent Npm1 And Runx1 Mutations, Zhuang Zuo, L Jeffrey Medeiros, C Cameron Yin

Faculty, Staff and Student Publications

NPM1 mutation, as a founding genetic event, cooperates with other gene mutations, such as DNMT3A and FLT3, to promote the development of acute myeloid leukemia. NPM1 mutation, however, has been reported to be mutually exclusive with RUNX1 mutation in acute myeloid leukemia cases. In this study, we analyzed mutation panel testing data from a relatively large cohort of rare AML cases with both NPM1 and RUNX1 mutations. We describe the dynamic process of the emergence of these mutations, as well as molecular genetic features and clinical outcome of these patients. We show that concurrence of both mutations in acute …

Integrated Clinical Genotype-Phenotype Characteristics Of Early T-Cell Precursor Acute Lymphoblastic Leukemia, Matthew T Ye, Yi Wang, Zhuang Zuo, Steliana Calin, Hua He, Zhenya Tang, Elias J Jabbour, Gautam Borthakur, Yizhuo Zhang, Yaling Yang, M James You

Faculty, Staff and Student Publications

Background: Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a distinct subtype of T-ALL with a unique immunophenotype and high treatment failure rate. The molecular genetic abnormalities and their prognostic impact in ETP-ALL patients are poorly understood.

Methods: The authors performed systematic analyses of the clinicopathologic features with an emphasis on molecular genetic aspects of 32 patients with ETP-ALL.

Results: The median age was 43 years (range, 16-71). The blasts were positive for cytoplasmic CD3 and CD7 and negative for CD1a and CD8. Other markers expressed included CD34 (88%), CD33 (72%), CD117 (68%), CD13 (58%), CD5 (partial, 56%), CD2 (38%), …

Revolutionizing Bone Regeneration: Advanced Biomaterials For Healing Compromised Bone Defects, Kamal Awad, Neelam Ahuja, Ahmed S Yacoub, Leticia Brotto, Simon Young, Antonios Mikos, Pranesh Aswath, Venu Varanasi

Faculty, Staff and Student Publications

In this review, we explore the application of novel biomaterial-based therapies specifically targeted towards craniofacial bone defects. The repair and regeneration of critical sized bone defects in the craniofacial region requires the use of bioactive materials to stabilize and expedite the healing process. However, the existing clinical approaches face challenges in effectively treating complex craniofacial bone defects, including issues such as oxidative stress, inflammation, and soft tissue loss. Given that a significant portion of individuals affected by traumatic bone defects in the craniofacial area belong to the aging population, there is an urgent need for innovative biomaterials to address the …

Ribonuclease 1 Enhances Antitumor Immunity Against Breast Cancer By Boosting T Cell Activation, Ying-Nai Wang, Heng-Huan Lee, Zhou Jiang, Li-Chuan Chan, Gabriel N Hortobagyi, Dihua Yu, Mien-Chie Hung

Faculty, Staff and Student Publications

The secretory enzyme human ribonuclease 1 (RNase1) is involved in innate immunity and anti-inflammation, achieving host defense and anti-cancer effects; however, whether RNase1 contributes to adaptive immune response in the tumor microenvironment (TME) remains unclear. Here, we established a syngeneic immunocompetent mouse model in breast cancer and demonstrated that ectopic RNase1 expression significantly inhibited tumor progression. Overall changes in immunological profiles in the mouse tumors were analyzed by mass cytometry and showed that the RNase1-expressing tumor cells significantly induced CD4+ Th1 and Th17 cells and natural killer cells and reduced granulocytic myeloid-derived suppressor cells, supporting that RNase1 favors an antitumor …

Sound Speed Estimation For Distributed Aberration Correction In Laterally Varying Media, Rehman Ali, Trevor M Mitcham, Melanie Singh, Marvin M Doyley, Richard R Bouchard, Jeremy J Dahl, Nebojsa Duric

Faculty, Staff and Student Publications

Spatial variation in sound speed causes aberration in medical ultrasound imaging. Although our previous work has examined aberration correction in the presence of a spatially varying sound speed, practical implementations were limited to layered media due to the sound speed estimation process involved. Unfortunately, most models of layered media do not capture the lateral variations in sound speed that have the greatest aberrative effect on the image. Building upon a Fourier split-step migration technique from geophysics, this work introduces an iterative sound speed estimation and distributed aberration correction technique that can model and correct for aberrations resulting from laterally varying …

Naproxen Chemoprevention Induces Proliferation Of Cytotoxic Lymphocytes In Lynch Syndrome Colorectal Mucosa, Charles M Bowen, Nan Deng, Laura Reyes-Uribe, Edwin Roger Parra, Pedro Rocha, Luisa M Solis, Ignacio I Wistuba, Valerie O Sepeda, Lana Vornik, Marjorie Perloff, Eva Szabo, Asad Umar, Krishna M Sinha, Powel H Brown, Eduardo Vilar

Faculty, Staff and Student Publications

BACKGROUND: Recent clinical trial data from Lynch Syndrome (LS) carriers demonstrated that naproxen administered for 6-months is a safe primary chemoprevention that promotes activation of different resident immune cell types without increasing lymphoid cellularity. While intriguing, the precise immune cell types enriched by naproxen remained unanswered. Here, we have utilized cutting-edge technology to elucidate the immune cell types activated by naproxen in mucosal tissue of LS patients.

METHODS: Normal colorectal mucosa samples (pre- and post-treatment) from a subset of patients enrolled in the randomized and placebo-controlled 'Naproxen Study' were obtained and subjected to a tissue microarray for image mass cytometry …

Membranous Nephropathy In Chronic Lymphocytic Leukemia Responsive To Ibrutinib: A Case Report, Anna-Eve Turcotte, William F Glass, Jamie S Lin, Jan A Burger

Faculty, Staff and Student Publications

Membranous nephropathy (MN) is an uncommon renal presentation in patients with chronic lymphocytic leukemia (CLL), and as such, there is no standard therapy for these patients. A few cases of MN in CLL have been described with varying success in MN treatment involving alkylating agents and fludarabine. Here we report the first case of MN in a patient with CLL treated with ibrutinib with complete renal response. This presentation underlines the importance of recognizing rare glomerular diseases that may occur with CLL and offers a new therapeutic avenue to the treatment of CLL-associated MN.

Machine Learning-Based Prediction Of Acute Mortality In Emergency Department Patients Using Twelve-Lead Electrocardiogram, Po-Cheng Chang, Zhi-Yong Liu, Yu-Chang Huang, Yu-Chun Hsu, Jung-Sheng Chen, Ching-Heng Lin, Richard Tsai, Chung-Chuan Chou, Ming-Shien Wen, Hung-Ta Wo, Wen-Chen Lee, Hao-Tien Liu, Chun-Chieh Wang, Chang-Fu Kuo

Faculty, Staff and Student Publications

BACKGROUND: The risk of mortality is relatively high among patients who visit the emergency department (ED), and stratifying patients at high risk can help improve medical care. This study aimed to create a machine-learning model that utilizes the standard 12-lead ECG to forecast acute mortality risk in ED patients.

METHODS: The database included patients who visited the EDs and underwent standard 12-lead ECG between October 2007 and December 2017. A convolutional neural network (CNN) ECG model was developed to classify survival and mortality using 12-lead ECG tracings acquired from 345,593 ED patients. For machine learning model development, the patients were …

Artificial Intelligence-Enabled Electrocardiographic Screening For Left Ventricular Systolic Dysfunction And Mortality Risk Prediction, Yu-Chang Huang, Yu-Chun Hsu, Zhi-Yong Liu, Ching-Heng Lin, Richard Tsai, Jung-Sheng Chen, Po-Cheng Chang, Hao-Tien Liu, Wen-Chen Lee, Hung-Ta Wo, Chung-Chuan Chou, Chun-Chieh Wang, Ming-Shien Wen, Chang-Fu Kuo

Faculty, Staff and Student Publications

BACKGROUND: Left ventricular systolic dysfunction (LVSD) characterized by a reduced left ventricular ejection fraction (LVEF) is associated with adverse patient outcomes. We aimed to build a deep neural network (DNN)-based model using standard 12-lead electrocardiogram (ECG) to screen for LVSD and stratify patient prognosis.

METHODS: This retrospective chart review study was conducted using data from consecutive adults who underwent ECG examinations at Chang Gung Memorial Hospital in Taiwan between October 2007 and December 2019. DNN models were developed to recognize LVSD, defined as LVEF

RESULTS: The mean age of patients in the testing dataset was 63.7 ± 16.3 years (46.3% …

Distinct Patterns Of Auto-Reactive Antibodies Associated With Organ-Specific Immune-Related Adverse Events, Mehmet Altan, Quan-Zhen Li, Qi Wang, Natalie I Vokes, Ajay Sheshadri, Jianjun Gao, Chengsong Zhu, Hai T Tran, Saumil Gandhi, Mara B Antonoff, Stephen Swisher, Jing Wang, Lauren A Byers, Noha Abdel-Wahab, Maria C Franco-Vega, Yinghong Wang, J Jack Lee, Jianjun Zhang, John V Heymach

Faculty, Staff and Student Publications

UNLABELLED: The roles of preexisting auto-reactive antibodies in immune-related adverse events (irAEs) associated with immune checkpoint inhibitor therapy are not well defined. Here, we analyzed plasma samples longitudinally collected at predefined time points and at the time of irAEs from 58 patients with immunotherapy naïve metastatic non-small cell lung cancer treated on clinical protocol with ipilimumab and nivolumab. We used a proteomic microarray system capable of assaying antibody reactivity for IgG and IgM fractions against 120 antigens for systemically evaluating the correlations between auto-reactive antibodies and certain organ-specific irAEs. We found that distinct patterns of auto-reactive antibodies at baseline were …