Pembrolizumab Induced Parsonage Turner Syndrome

2020 ◽  
pp. 10.1212/CPJ.0000000000000994
Author(s):  
Dinesh Keerty ◽  
Edwin Peguero
Keyword(s):  
Adverse Effect ◽  
Adverse Effects ◽  
Turner Syndrome ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Abrupt Onset ◽  
Brachial Plexopathy ◽  
Motor Weakness ◽  
Neuralgic Amyotrophy

Parsonage-Turner Syndrome (PTS), also referred to as idiopathic brachial plexopathy or neuralgic amyotrophy, is a rare disorder consisting of a complex constellation of symptoms1. It has an abrupt onset of unilateral shoulder pain followed by progressive neurologic deficits of motor weakness, dysesthesias, and numbness2. The etiology of the syndrome is unclear. Immune checkpoint inhibitors (ICPIs) have been known to cause a myriad of neurological adverse effects. We present a patient that developed PTS as an adverse effect from pembrolizumab treatment.

scholarly journals Adverse Effects of Immune-Checkpoint Inhibitors in Hepatocellular Carcinoma

2020 ◽  
Vol Volume 13 ◽  
pp. 11725-11740
Author(s):  
Tian-ming Cui ◽  
Yao Liu ◽  
Jia-bei Wang ◽  
Lian-xin Liu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Adverse Effects ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors

scholarly journals Immune-related Adverse Effects and Outcome of Patients With Cancer Treated With Immune Checkpoint Inhibitors

2020 ◽  
Vol 40 (3) ◽  
pp. 1219-1227 ◽  
Author(s):  
ONDREJ FIALA ◽  
ONDREJ SOREJS ◽  
JAN SUSTR ◽  
RADEK KUCERA ◽  
ONDREJ TOPOLCAN ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Patients With Cancer

Ophthalmic adverse effects of immune checkpoint inhibitors: the Mayo Clinic experience

2020 ◽  
pp. bjophthalmol-2020-316970 ◽  
Author(s):  
Blake Hugo Fortes ◽  
Harris Liou ◽  
Lauren A Dalvin
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Immune Checkpoint ◽  
Ocular Surface ◽  
Side Effect ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
Common Side Effect ◽  
Targeting Therapy

Background/AimsTo investigate immune-related ophthalmic side effects of systemic checkpoint inhibitors and compare side effect frequency and requirement for cessation of immunotherapy by checkpoint target.MethodsPatients taking immune checkpoint inhibitors at a single centre from January 1, 2010 to February 29, 2020 were retrospectively reviewed for clinical characteristics, treatments and concurrent systemic adverse effects.ResultsOf 996 patients, 28 (2.8%) experienced an ophthalmic side effect that came to the attention of an eye care provider. Mean age at presentation of the side effect was 63 years (median 64, range 25–88). The checkpoint inhibitor most often preceding side effects was pembrolizumab in 12 (43%). The most common side effect was dry eye in 16 (57%), followed by uveitis in 4 (14%) patients, and singular cases of ptosis and binocular diplopia, among others. Ocular surface adverse effects occurred more frequently with programmed death ligand-1 (PD-L1) targeting therapy. There were no significant differences in the frequency of orbit/ocular adnexa and uveitis or retinal side effects based on checkpoint targets. Follow-up was available in 13 (46%) patients, with mean duration of 20 months (median 16, range 2–52 months). Of these patients, the ophthalmic side effects were controlled without discontinuing therapy in 12 (92%). Checkpoint inhibitor cessation was required in one patient with panuveitis.ConclusionOphthalmic immune-related adverse events are rare but could be more common than previously estimated. PD-L1-directed checkpoint inhibitors may have a slight predilection for ocular surface adverse effects. Most ophthalmic events can be treated with targeted therapy without discontinuation of life-prolonging immunotherapy.

Dermatologic adverse events with immune checkpoint blockade: Systematic review and meta-analysis.

2020 ◽  
Vol 38 (5_suppl) ◽  
pp. 84-84
Author(s):  
Kushal Naha ◽  
Lakshmi Manogna Chintalacheruvu ◽  
Donald C. Doll ◽  
Sowjanya Naha
Keyword(s):  
Adverse Effects ◽  
Adverse Events ◽  
Confidence Interval ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
Randomized Controlled ◽  
Dermatologic Adverse Events

84 Background: Immune checkpoint blockade is known to be associated with various dermatologic adverse events. However, these adverse effects have not been studied in a systematic manner. This is especially relevant considering the rapidly increasing number of immune checkpoint inhibitors that are now available. Methods: We searched for eligible studies in PubMed and Google scholar. We reviewed randomized controlled trials involving cancer patients treated with immune checkpoint inhibitors - PD1 inhibitors, PDL1 inhibitors and CTLA4 inhibitors and for dermatologic adverse effects. A total of 47 randomized controlled trials involving 11875 patients met eligibility criteria for our study. Results: Incidence rate of all grade dermatologic adverse effects was 40.6% (95% confidence interval [CI], 39.4-41.7%). Most common adverse effects included pruritus (17.3%) (95% confidence interval [CI] 16.6-18.1%), undifferentiated rash (15.1%) (95% confidence interval [CI] 14.4-15.9%), vitiligo (3.6%) (95% confidence interval [CI] 3.2-3.9%), maculopapular rash (2.3%) (95% confidence interval [CI] 2.1-2.6%), stomatitis (0.7%) (95% confidence interval [CI] 0.55-0.92%) and dry skin (0.7%) (95% confidence interval [CI] 0.5-0.8%). Less common adverse events include palmoplantar erythrodysesthesia, pemphigoid skin reactions, lichen planus and hyperhidrosis. Grade 3 and higher adverse effects were seen in 1.3% of patients (95% confidence interval [CI] 1.1-1.6%). Conclusions: A wide range of dermatologic adverse effects can be seen with immune checkpoint blockade. While the majority of these events are of grade 1-2, they can occasionally be severe and even life threatening. Patients receiving immune checkpoint blockade should be closely monitored for dermatologic adverse effects.

scholarly journals Hepatic Immune-Mediated-Adverse-Effects of Immune Checkpoint Inhibitors: Analysis of Real-Life Experience

2021 ◽  
pp. 100561
Author(s):  
Joana Alves da Silva ◽  
Daniela Falcão ◽  
Cláudia Cardoso ◽  
Ana Luísa Pires ◽  
António Araújo ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Life Experience ◽  
Checkpoint Inhibitors ◽  
Real Life ◽  
Immune Mediated

Endocrine and metabolic adverse effects of immune checkpoint inhibitors: an overview (what endocrinologists should know)

2018 ◽  
Vol 42 (7) ◽  
pp. 745-756 ◽  
Author(s):  
R. M. Ruggeri ◽  
A. Campennì ◽  
G. Giuffrida ◽  
P. Trimboli ◽  
L. Giovanella ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors

Immune-related intestinal pseudo-obstruction associated with nivolumab treatment in a lung cancer patient

2017 ◽  
Vol 25 (2) ◽  
pp. 487-491 ◽  
Author(s):  
Georgios Fragulidis ◽  
Eirini Pantiora ◽  
Vasiliki Michalaki ◽  
Elissaios Kontis ◽  
Elias Primetis ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Adverse Effects ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
High Dose ◽  
Checkpoint Inhibition ◽  
Immune Checkpoint Inhibition ◽  
Gradual Improvement ◽  
Organ Systems

Immune checkpoint inhibition therapy using targeted monoclonal antibodies is a new therapeutic approach with significant survival benefit for patients with several cancer types. However, their use can be associated with unique immune-related adverse effects as a consequence of impaired self-tolerance due to loss of T-cell inhibition via a nonselective activation of the immune system. Nivolumab is an anti-PD-1 immune checkpoint inhibitor that was recently developed for cancer immunotherapy with remarkable responses in nonsmall cell lung cancer patients. We present a 62-year-old Caucasian male with recurrent lung adenocarcinoma and currently under third-line therapy with nivolumab, who was admitted in our hospital with abdominal distension. Radiologic findings were consistent with small bowel ileus. After four days of conservative treatment, the patient underwent exploratory laparotomy where no cause of ileus was discovered. Postoperative the ileus persisted and considering that an adverse effect of the immune checkpoint inhibition therapy occurred, the patient received high-dose prednisone resulting in gradual improvement of symptoms. Immune checkpoint inhibitors may induce adverse effects to unaffected organ systems and tissues including the skin, gastrointestinal, hepatic, pulmonary, and endocrine system. The mainstay treatment consists of immunosuppression with corticosteroids in the majority of cases. As the clinical use of immune checkpoint inhibitors is expanding rapidly, there is an emergence of unique immune-related adverse effects in a growing patient population. Gaining early awareness is essential in these patients in order to ensure prompt diagnosis and management.

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