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Polymyalgia rheumatica due to pembrolizumab therapy
Andrew Iskandar1, Andrew Hwang1, Constantin A Dasanu2,3
11 Department of Medicine, Eisenhower Medical Center, Rancho Mirage, CA, USA.
Summary
Pembrolizumab, an immunotherapy drug, can rarely cause severe autoimmune reactions like polymyalgia rheumatica. Early recognition and steroid treatment are crucial for managing this rare toxicity.
Area of Science:
- Immunology
- Oncology
- Rheumatology
Background:
- Pembrolizumab is an anti-programmed cell death 1 antibody used to treat various cancers.
- While generally safe, pembrolizumab can induce autoimmune adverse events, which are usually mild.
- Severe autoimmune toxicities, though rare, pose significant risks to patients.
Observation:
- A unique case presented with severe proximal muscle weakness and joint pain.
- Symptoms emerged shortly after initiating pembrolizumab therapy.
- Diagnostic work-up showed elevated pro-inflammatory markers.
Findings:
- The patient was diagnosed with polymyalgia rheumatica, a rare autoimmune complication.
- Prompt administration of corticosteroids led to symptom resolution.
- This case highlights an unusual presentation of pembrolizumab-induced autoimmunity.
Implications:
- Clinicians should be aware of polymyalgia rheumatica as a potential rare side effect of pembrolizumab.
- Early diagnosis and management with steroids can effectively treat this condition.
- Increased awareness may prevent severe outcomes associated with this rare toxicity.
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