Cytokine release syndrome caused by immune checkpoint inhibitor: a case report

Abstract

Objective To investigate the diagnosis and treatment of cytokine release syndrome (CRS) caused by immune checkpoint inhibitor(ICI). Methods A case of ICI pembrolizumab leading to CRS was analyzed in Department of Pulmonary and Critical Care Medicine of Peking Union Medical College Hospital. ResultsA 52-year-old woman with advanced adenosquamous lung cancer developed fever and hypotension after receiving pembrolizumab. Results of laboratory test showed an obviously increased serum ferritin, C response protein, interleukin-6 and abnormal liver function. Without positive infectious results, she was ultimately diagnosed as CRS. The patient was treated with steroids and tocilizumab with good clinical response. Conclusions CRS caused by ICIs develops rapidly and lead to severe results. It is important to consider CRS in patient who developed systemic inflammatory response syndrome after ICIs. Steroids combined tocilizumab is a potential choice of treatment.

Keywords

• immune checkpoint inhibitor|cytokine release syndrome|systemic inflammatory response syndrome|lung cancer