Immune checkpoint inhibitor-related pneumonitis with atypical radiologic features in a patient with anti-aminoacyl-tRNA synthetase antibody. (2023)

• Record Type: Journal Article
• Authors: Ichihara, Seiya; Ogino, Hirokazu; Yoneda, Hiroto; Haji, Keiko; Kagawa, Kozo; Murakami, Kojin; Mima, Masato; Aoi, Yu; Mitsuhashi, Atsushi; Tsukazaki, Yuki; Yabuki, Yohei; Ozaki, Ryohiko; Sato, Seidai; Nokihara, Hiroshi; Nishioka, Yasuhiko
• Is Part Of: Respiratory medicine case reports. Volume 41(2023)
• Publication Date: 2023
• Subjects: Non-small-cell lung cancer -- Immune checkpoint inhibitor -- Pneumonitis -- Anti-aminoacyl-tRNA synthetase antibody; ICIs immune checkpoint inhibitors -- PD-1 programmed cell death-1 -- PD-L1 programmed cell death-ligand-1 -- NSCLC non-small-cell lung cancer -- PFS progression-free survival -- OS overall survival -- RR response rate -- irAEs immune-related adverse events -- ARS aminoacyl tRNA synthetases -- HRCT high-resolution computed tomography -- EGFR epidermal growth factor receptor -- ALK anaplastic lymphoma kinase -- ANAs anti-nuclear antibodies -- GGO ground-glass opacity -- OP organizing pneumonia -- HP hypersensitivity pneumonitis -- NSIP nonspecific interstitial pneumonia -- UIP usual interstitial pneumonia -- ILD interstitial lung disease -- CTCAE common terminology criteria for adverse events -- ASS anti-synthetase syndrome -- IIM idiopathic inflammatory myopathy; Respiratory organs -- Diseases -- Periodicals; Chest -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System -- Periodicals; Chest -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; 616.2
• DOI: 10.1016/j.rmcr.2022.101797
• Languages: English
• ISSNs: 2213-0071

Abstract

Abstract: A man with non-small-cell lung cancer who was negative for anti-nuclear antibodies was admitted for dyspnea after immune checkpoint inhibitor (ICI) administration. Computed tomography (CT) showed complexed radiologic features, including subpleural and basal predominant reticular shadow with cystic structures and peribronchovascular consolidation. Although we treated him with high-dose steroid under a diagnosis of ICI-related pneumonitis, he developed acute exacerbation of pneumonitis with progressive fibrosis and volume loss. A re-evaluation identified anti-aminoacyl-tRNA synthetase antibody in the serum collected before ICI administration. This case highlights the importance of re-evaluating pre-existing autoimmune disorders in patients who develop ICI-related pneumonitis with atypical radiologic features.