Digital ischemia: a rare immune-related adverse event of immune checkpoint inhibitors-case report and review of the literature.

Autor: Yerolatsite M; Department of Medical Oncology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Torounidou N; Department of Medical Oncology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Venetsanopoulou AI; Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Zarkavelis G; Department of Medical Oncology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Mauri D; Department of Medical Oncology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Voulgari PV; Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece. pvoulgar@uoi.gr.; Department of Internal Medicine, Medical School, Rheumatology Clinic, University of Ioannina, 45110, Ioannina, Greece. pvoulgar@uoi.gr.
Jazyk: angličtina
Zdroj: Rheumatology international [Rheumatol Int] 2024 Dec; Vol. 44 (12), pp. 3141-3149. Date of Electronic Publication: 2024 Sep 04.
DOI: 10.1007/s00296-024-05709-y
Abstrakt: Immune checkpoint inhibitors (ICIs) play a crucial role in treating various cancers. While ICIs are invaluable in the fight against different cancers, they also pose the risk of immune-related adverse events (irAEs), which can range widely in symptoms and severity. Rheumatologic complications, including digital ischemia, are among the irAEs. While rare, they require early detection for effective management. The aim of the study is to present a case report on digital ischemia related to immunotherapy and to conduct a literature review on relevant cases. We present a case involving a patient from our oncology department who developed, pericarditis, digital ischemia and anti-centromere antibodies during immunotherapy with pembrolizumab for non-small cell lung cancer (NSCLC). We collaborated with our rheumatology department to initiate treatment, including corticosteroids, iloprost, and mycophenolate mofetil. Through the follow-up, the patient showed clinical improvement. A literature review identified only 10 relevant articles, highlighting the rarity of digital ischemia as an irAE. Corticosteroids and vasodilators were commonly used treatments, with amputation unavoidable in 40% of cases. IrAEs are becoming more common due to the widespread use of ICIs. For this reason, it is crucial to diagnose and treat rare IrAEs, such as digital ischemia, as early as possible to improve outcomes.
Competing Interests: Declarations. Conflict of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Ethical approval: This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of General University Hospital of Ioannina (protocol code 649/17–07-2024). Informed consent: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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