Pembrolizumab-associated anti-MDA5 dermatomyositis in a patient with lung cancer: a first case report

We report the first case of anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis as a systemic immune-related adverse event in a 64-year-old man receiving pembrolizumab to treat advanced lung cancer. The patient experienced hypothyroidism, myalgia, skin involvement, dyspn...

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Bibliographic Details
Main Authors: Antonino Marcello Pilia, Lorenzo Salvati, Alessia Guidolin, Francesca Mazzoni, Lorenzo Antonuzzo, Paola Parronchi, Francesco Liotta
Format: Article
Language:English
Published: SMW supporting association (Trägerverein Swiss Medical Weekly SMW) 2024-03-01
Series:Swiss Medical Weekly
Online Access:https://smw.ch/index.php/smw/article/view/3513
Description
Summary:We report the first case of anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis as a systemic immune-related adverse event in a 64-year-old man receiving pembrolizumab to treat advanced lung cancer. The patient experienced hypothyroidism, myalgia, skin involvement, dyspnoea and diarrhoea. Laboratory tests revealed raised inflammatory markers, hypercreatinekinasemia and anti-MDA5 autoantibodies. Electroneuromyography and pathognomonic signs on physical examination confirmed the diagnosis of pauci-myopathic dermatomyositis. Pembrolizumab was discontinued and immunosuppressive therapy led to rapid and progressive improvement, with complete remission of dermatomyositis. This case report widens the spectrum of systemic immune-related adverse events associated with pembrolizumab.
ISSN:1424-3997