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Pembrolizumab-Induced Thyroiditis and Colitis-Presentation and Resolution on Serial FDG PET/CT
Immune checkpoint inhibitors like pembrolizumab can cause immune-related adverse events, including thyroiditis and colitis. Discontinuation of pembrolizumab often resolves these inflammatory changes, as seen in this melanoma patient.
Area of Science:
- Oncology
- Immunology
- Nuclear Medicine
Background:
- Pembrolizumab, an immune checkpoint inhibitor, is used for melanoma treatment.
- 18F-FDG PET/CT is a key imaging modality for staging and monitoring metastatic disease.
Observation:
- A patient receiving pembrolizumab for metastatic melanoma developed increased thyroid and colonic uptake on FDG PET/CT.
- These findings were suggestive of immune-related thyroiditis and colitis.
Findings:
- Partial metabolic response of metastatic disease was observed.
- Cessation of pembrolizumab led to the resolution of thyroid and colonic inflammatory changes.
- FDG PET/CT confirmed the regression of uptake in affected organs.
Implications:
- Recognizing immune-related adverse events from immune checkpoint inhibitors is crucial.
- Discontinuation of treatment can effectively manage these side effects.
- FDG PET/CT is valuable in diagnosing and monitoring immune-related adverse events.
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