Tenosynovitis Induced by an Immune Checkpoint Inhibitor: A Case Report and Literature Review

A 51-year-old man underwent second-line treatment for non-small-cell lung cancer (NSCLC) with the immune checkpoint inhibitor (ICI) pembrolizumab. On day 2 after two cycles of pembrolizumab, he presented with edema limited to the left third, fourth, and fifth fingers. Based on symptoms, laboratory r...

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Bibliographic Details
Published in:Internal Medicine 2019/10/01, Vol.58(19), pp.2839-2843
Main Authors: Murakami, Shoko, Nagano, Tatsuya, Nakata, Kyosuke, Onishi, Akira, Umezawa, Kanoko, Katsurada, Naoko, Yamamoto, Masatsugu, Tachihara, Motoko, Kobayashi, Kazuyuki, Nishimura, Yoshihiro
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal, Humanized - adverse effects
Antibodies, Monoclonal, Humanized - therapeutic use
Antineoplastic Agents, Immunological - adverse effects
Antineoplastic Agents, Immunological - therapeutic use
Carcinoma, Non-Small-Cell Lung - drug therapy
Case Report
Edema
Fingers - diagnostic imaging
Glucocorticoids - therapeutic use
Humans
Immune checkpoint inhibitors
Internal medicine
Literature reviews
Lung cancer
Lung Neoplasms - drug therapy
Magnetic Resonance Imaging
Male
Middle Aged
Monoclonal antibodies
NMR
Non-small cell lung carcinoma
Nuclear magnetic resonance
Pembrolizumab
Prednisolone
Prednisolone - therapeutic use
Prednisone
Small cell lung carcinoma
Targeted cancer therapy
Tenosynovitis
Tenosynovitis - chemically induced
Tenosynovitis - diagnosis
Tenosynovitis - drug therapy
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Description
Summary:A 51-year-old man underwent second-line treatment for non-small-cell lung cancer (NSCLC) with the immune checkpoint inhibitor (ICI) pembrolizumab. On day 2 after two cycles of pembrolizumab, he presented with edema limited to the left third, fourth, and fifth fingers. Based on symptoms, laboratory results, and contrast-enhanced magnetic resonance imaging (MRI) findings, we diagnosed him with tenosynovitis. We prescribed oral prednisolone (0.5 mg/kg/day), and pembrolizumab was continued. Prednisolone immediately relieved the symptoms, and the tumor was still shrinking on day 21 after eight cycles of pembrolizumab. ICI-induced tenosynovitis was managed while continuing ICI usage, suggesting that 0.5 mg/kg/day prednisone might be effective for tenosynovitis without ICI cessation.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.2556-19