Key result
A patient who developed life-threatening cardiac tamponade and secondary adrenal insufficiency due to pembrolizumab successfully recovered after prompt initiation of corticosteroid therapy.
Case Report (n=1)
Prompt initiation of corticosteroid therapy is crucial for managing life-threatening immune-related adverse events, such as cardiac tamponade and adrenal insufficiency, caused by anti-PD-1 monoclonal antibodies.
May support prompt steroids in pembrolizumab-related tamponade with adrenal failure; hypothesis-generating case report requiring confirmation.
INTRODUCTION: Patients who receive or have received anti-programmed cell-death-1 (PD-1) monoclonal antibodies can develop immune-related adverse events due to activation of the immune system. CASE PRESENTATION: We report a case of a patient who received pembrolizumab and presented with cardiac tamponade. Despite pericardial drainage, she persisted with refractory arterial hypotension due to secondary adrenal insufficiency. After initiating corticosteroid therapy, the patient recovered successfully. DISCUSSION: The association of pericarditis, hypophysitis and thyroid dysfunction support the diagnosis of a life-threatening immune-related adverse event due to pembrolizumab. In case of immune-related adverse events secondary to anti-PD-1 monoclonal antibodies, corticosteroid therapy should be promptly initiated in order to avoid major complications.
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Oristrell et al. (2018) conducted a case report in Cardiac tamponade and adrenal insufficiency (n=1). Pembrolizumab was evaluated. A patient who developed life-threatening cardiac tamponade and secondary adrenal insufficiency due to pembrolizumab successfully recovered after prompt initiation of corticosteroid therapy.
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