Hemophagocytic Lymphohistiocytosis in a Patient with Rheumatoid Arthritis on Pembrolizumab for Lung Adenocarcinoma

Yu Akagi; Nobuyasu Awano; Minoru Inomata; Naoyuki Kuse; Mari Tone; Hanako Yoshimura; Tatsunori Jo; Kohei Takada; Toshio Kumasaka; Takehiro Izumo

doi:10.2169/internalmedicine.3889-19

CASE REPORTS

Hemophagocytic Lymphohistiocytosis in a Patient with Rheumatoid Arthritis on Pembrolizumab for Lung Adenocarcinoma

Yu Akagi, Nobuyasu Awano, Minoru Inomata, Naoyuki Kuse, Mari Tone, Hanako Yoshimura, Tatsunori Jo, Kohei Takada, Toshio Kumasaka, Takehiro Izumo

Author information

Yu Akagi
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan
Nobuyasu Awano
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan
Minoru Inomata
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan
Naoyuki Kuse
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan
Mari Tone
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan
Hanako Yoshimura
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan
Tatsunori Jo
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan
Kohei Takada
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan
Toshio Kumasaka
Department of Pathology, Japanese Red Cross Medical Center, Japan
Takehiro Izumo
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan

Keywords: pembrolizumab, hemophagocytic lymphohistiocytosis, immune checkpoint inhibitors, lung cancer, rheumatoid arthritis, immune-related adverse event

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 8 Pages 1075-1080

DOI https://doi.org/10.2169/internalmedicine.3889-19

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Abstract

Immune checkpoint inhibitors have changed the landscape of classic cancer treatment. However, their use is associated with the emergence of new adverse events. An elderly man with rheumatoid arthritis was started on pembrolizumab for newly diagnosed advanced lung cancer. He subsequently developed hemophagocytic lymphohistiocytosis (HLH), which is potentially fatal but has not been properly established as an immune checkpoint inhibition-induced event. We herein report the case of a patient with pembrolizumab-induced HLH.

Corresponding author

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