Severe pulmonary toxicity from immune checkpoint inhibitor treated successfully with intravenous immunoglobulin: Case report and review of the literature

Immune checkpoint inhibitors are known to cause a variety of immune-related adverse events, including pneumonitis. When symptomatic, treatment typically consists of temporary or permanent cessation of the checkpoint inhibitor and several weeks of corticosteroid therapy. However, a subset of patients...

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Bibliographic Details
Published in:Respiratory medicine case reports 2019-01, Vol.27, p.100834, Article 100834
Main Authors: Petri, Camille R., Patell, Rushad, Batalini, Felipe, Rangachari, Deepa, Hallowell, Robert W.
Format: Article
Language:English
Subjects:
Immune checkpoint inhibitor
Intravenous immunoglobulin
Pneumonitis
Pulmonary toxicity
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Summary:Immune checkpoint inhibitors are known to cause a variety of immune-related adverse events, including pneumonitis. When symptomatic, treatment typically consists of temporary or permanent cessation of the checkpoint inhibitor and several weeks of corticosteroid therapy. However, a subset of patients may suffer from severe pneumonitis, and the optimal treatment for this group is not known. Here we describe the case of a patient receiving pembrolizumab for non-small cell lung cancer who developed severe checkpoint inhibitor pneumonitis. After treatment with high-dose corticosteroids failed to produce a response, a course of intravenous immunoglobulin catalyzed rapid and durable improvement. In this review, we discuss the current evidence regarding the incidence and outcomes of severe checkpoint inhibitor pneumonitis and propose a role for intravenous immunoglobulin as a possible treatment strategy.
ISSN:2213-0071
2213-0071
DOI:10.1016/j.rmcr.2019.100834