Muscle weakness, myositis and scleroderma induced by durvalumab

Immune checkpoint inhibitors (ICI) have shown a change in the prognosis of multiple malignancies, but a wide range of immune-related adverse events (irAE) can occur. We present a case of a 72-year-old Caucasian male treated with Durvalumab for epidermic lung cancer, who developed a sclerosis-like syndrome and myositis. The patient was admitted to our hospital with respiratory failure due to muscular weakness and pulmonary hypertension. Differential diagnoses pointed to scleroderma secondary to ICI. We report a rare case of ICI-induced axonal polyneuropathy, myopathy and RNA polymerase III positive scleroderma. As this therapy is widely recommended, adverse effects may become more frequent. Early identification and treatment are warranted.