Carpal Tunnel Syndrome Associated with Immune Checkpoint Inhibitors

Abstract

Immune checkpoint inhibitors (ICIs) have transformed the therapeutic approach to diverse malignancies, leading to substantial enhancements in patient prognosis. However, along with their benefits, ICIs also increase the incidence of immune-related adverse events (irAEs). In the present paper, we highlight four cases of carpal tunnel syndrome (CTS) as an uncommon manifestation of toxicity induced by ICIs. Although diagnosed with different malignancies, the patients were undergoing ICI therapy when they developed CTS-consistent side effects accompanied by severe neuropathy. Prompt treatment with corticosteroids, intravenous immunoglobulins, or methotrexate resulted in complete symptomatic relief for all patients. This article therefore emphasizes the importance of recognizing and managing rare adverse events associated with ICI use to ensure optimal patient care.

Keywords

• PD1 inhibitor
• PDL-1 inhibitor
• carpal tunnel syndrome (CTS)
• non-small-cell lung cancer (NSCLC)
• renal cell carcinoma (RCC)
• malignant melanoma (MM)