[Reactive arthritis after treatment with immune checkpoint inhibitors: A case report]

Immune checkpoint inhibitors (ICIs) have transformed cancer therapy, but immune-related adverse events are common. Reactive arthritis-like syndromes remain rarely reported in this context.

We report the case of a 73-year-old man with a history of clear cell renal carcinoma who developed conjunctivitis, urethritis, and asymmetric arthritis 48hours after receiving pembrolizumab. Synovial fluid analysis was sterile, the autoimmune panel was negative, and imaging excluded axial spondyloarthritis. Symptoms recurred during glucocorticoids tapering but improved after intra-articular injections and prednisone reinitiation. A pharmacovigilance analysis using VigiBase identified eleven similar cases, including three classified as Fiessinger-Leroy-Reiter syndrome.

This case illustrates a rare presentation of pembrolizumab-associated reactive arthritis, combining articular involvement with an oculo-urethral syndrome. It underscores the importance of a thorough diagnostic workup and early multidisciplinary management.