Development of Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome with Pembrolizumab for Lung Squamous Cell Carcinoma

Intern Med. 2024 Jul 15;63(14):2089-2096. doi: 10.2169/internalmedicine.2475-23. Epub 2023 Dec 11.

Abstract

Immune checkpoint inhibitors (ICIs) can cause immune-related adverse events (irAEs). There are a few case reports of remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) as an irAE. We herein report a 49-year-old Japanese man who developed acute-onset polyarthralgia and edema of the back of both hands and bilateral lower legs after pembrolizumab administration for lung cancer. The patient's lung cancer was in complete remission, leading to the diagnosis of RS3PE induced by pembrolizumab rather than malignancy. When patients show RS3PE during ICI treatment, rheumatologists should consider the possibility of an irAE after excluding malignancy and systemic diseases.

Keywords: immune-related adverse events; remitting seronegative symmetrical synovitis with pitting edema syndrome.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized* / adverse effects
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / therapeutic use
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / drug therapy
  • Edema* / chemically induced
  • Edema* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Immune Checkpoint Inhibitors / therapeutic use
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Male
  • Middle Aged
  • Syndrome
  • Synovitis* / chemically induced
  • Synovitis* / drug therapy

Substances

  • pembrolizumab
  • Antibodies, Monoclonal, Humanized
  • Immune Checkpoint Inhibitors
  • Antineoplastic Agents, Immunological