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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doaj-27da89c6fba448568ad2a280f1be50242020-11-24T21:58:31ZengElsevierRespiratory Medicine Case Reports2213-00712019-01-0127Severe pulmonary toxicity from immune checkpoint inhibitor treated successfully with intravenous immunoglobulin: Case report and review of the literatureCamille R. Petri0Rushad Patell1Felipe Batalini2Deepa Rangachari3Robert W. Hallowell4Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Corresponding author. Beth Israel Deaconess Medical Center, 330 Brookline Avenue, KS-B23, Boston, MA 02215, USA.Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USADivision of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USADivision of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USADivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USAImmune 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. Keywords: Immune checkpoint inhibitor, Pneumonitis, Pulmonary toxicity, Intravenous immunoglobulinhttp://www.sciencedirect.com/science/article/pii/S2213007119300218 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Camille R. Petri Rushad Patell Felipe Batalini Deepa Rangachari Robert W. Hallowell |
spellingShingle |
Camille R. Petri Rushad Patell Felipe Batalini Deepa Rangachari Robert W. Hallowell Severe pulmonary toxicity from immune checkpoint inhibitor treated successfully with intravenous immunoglobulin: Case report and review of the literature Respiratory Medicine Case Reports |
author_facet |
Camille R. Petri Rushad Patell Felipe Batalini Deepa Rangachari Robert W. Hallowell |
author_sort |
Camille R. Petri |
title |
Severe pulmonary toxicity from immune checkpoint inhibitor treated successfully with intravenous immunoglobulin: Case report and review of the literature |
title_short |
Severe pulmonary toxicity from immune checkpoint inhibitor treated successfully with intravenous immunoglobulin: Case report and review of the literature |
title_full |
Severe pulmonary toxicity from immune checkpoint inhibitor treated successfully with intravenous immunoglobulin: Case report and review of the literature |
title_fullStr |
Severe pulmonary toxicity from immune checkpoint inhibitor treated successfully with intravenous immunoglobulin: Case report and review of the literature |
title_full_unstemmed |
Severe pulmonary toxicity from immune checkpoint inhibitor treated successfully with intravenous immunoglobulin: Case report and review of the literature |
title_sort |
severe pulmonary toxicity from immune checkpoint inhibitor treated successfully with intravenous immunoglobulin: case report and review of the literature |
publisher |
Elsevier |
series |
Respiratory Medicine Case Reports |
issn |
2213-0071 |
publishDate |
2019-01-01 |
description |
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. Keywords: Immune checkpoint inhibitor, Pneumonitis, Pulmonary toxicity, Intravenous immunoglobulin |
url |
http://www.sciencedirect.com/science/article/pii/S2213007119300218 |
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