Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report.

Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report. - 2021

Cytokine release syndrome (CRS) is a well-described immune-related adverse event following chimeric antigen receptor T-cell therapy, but has rarely been reported following anti-programmed death ligand-1 therapy. We report the case of a 55-year-old man with metastatic lung adenocarcinoma who presented with fever, chills and hypotension. Initial labs were notable for highly elevated serum ferritin levels and mildly elevated triglyceride levels. He was ultimately diagnosed with pembrolizumab-induced CRS complicated by multiorgan failure. The patient was treated with steroids and tocilizumab with normalization of inflammatory markers and resolution of renal failure. This case not only highlights the importance of considering CRS in patients who have developed multiorgan failure after immune checkpoint inhibitor therapy, but also demonstrates clinical similarities between CRS and other hyperinflammatory states such as hemophagocytic lymphohistiocytosis. Copyright (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


English

2051-1426


*Adenocarcinoma of Lung/dt [Drug Therapy]
*Antibodies, Monoclonal, Humanized/ae [Adverse Effects]
*Antineoplastic Agents, Immunological/tu [Therapeutic Use]
*Cytokine Release Syndrome/ci [Chemically Induced]
Adenocarcinoma of Lung/sc [Secondary]
Antibodies, Monoclonal, Humanized/pd [Pharmacology]
Antineoplastic Agents, Immunological/pd [Pharmacology]
Humans
Male
Middle Aged
Neoplasm Metastasis


Internal Medicine Residency
MedStar Georgetown University Hospital


Journal Article

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