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CASE REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 |
doi: 10.3389/fimmu.2024.1370972
IgA vasculitis induced by carboplatin + nab-paclitaxel + pembrolizumab in a patient with advanced lung squamous cell carcinoma: A case report
Provisionally accepted
Yuto Terashima
Masaru Matsumoto
*
Saeko Ozaki
*
Michiko Nakagawa
*
Shun Nakagome
*
Yasuhiro Terasaki
*
Hiroki Iida
*
Ryotaro Mitsugi
*
Eri Kuramochi
*
Naoko Okada
*
Tomoyasu Inoue
*
Satoru Matsuki
*
Shingo Kitagawa
*
Aya Fukuizumi
*
Naomi Onda
*
Susumu Takeuchi
*
Akihiko Miyanaga
Kazuo Kasahara
*
Masahiro Seike
*- Nippon Medical School, Bunkyō, Japan
A 73-year-old man with lung squamous cell carcinoma was administered carboplatin + nab-paclitaxel + pembrolizumab for four cycles. Subsequently, he presented with multiple purpuras on his extremities, joint swelling on his fingers, abdominal pain, and diarrhea, accompanied by acute kidney injury (AKI), increased proteinuria, hematuria, and elevated C-reactive protein levels. Skin biopsy showed leukocytoclastic vasculitis as well as IgA and C3 deposition in the vessel walls. Based on these findings, the patient was diagnosed with IgA vasculitis as an immune-related adverse event (irAE) induced by carboplatin + nab-paclitaxel + pembrolizumab. After discontinuation of pembrolizumab and glucocorticoids, the symptoms immediately resolved. Regular monitoring of skin, blood tests, and urinalysis are necessary, and the possibility of irAE IgA vasculitis should be considered in cases of purpura and AKI during treatment with immune checkpoint inhibitors.
Keywords: IgA vasculitis, Immune-related adverse event, Immune checkpoint inhibitor, Pembrolizumab, non-small-cell lung cancer
Received: 15 Jan 2024; Accepted: 30 Jul 2024.
Copyright: © 2024 Terashima, Matsumoto, Ozaki, Nakagawa, Nakagome, Terasaki, Iida, Mitsugi, Kuramochi, Okada, Inoue, Matsuki, Kitagawa, Fukuizumi, Onda, Takeuchi, Miyanaga, Kasahara and Seike. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Masaru Matsumoto, Nippon Medical School, Bunkyō, Japan
Saeko Ozaki, Nippon Medical School, Bunkyō, Japan
Michiko Nakagawa, Nippon Medical School, Bunkyō, Japan
Shun Nakagome, Nippon Medical School, Bunkyō, Japan
Yasuhiro Terasaki, Nippon Medical School, Bunkyō, Japan
Hiroki Iida, Nippon Medical School, Bunkyō, Japan
Ryotaro Mitsugi, Nippon Medical School, Bunkyō, Japan
Eri Kuramochi, Nippon Medical School, Bunkyō, Japan
Naoko Okada, Nippon Medical School, Bunkyō, Japan
Tomoyasu Inoue, Nippon Medical School, Bunkyō, Japan
Satoru Matsuki, Nippon Medical School, Bunkyō, Japan
Shingo Kitagawa, Nippon Medical School, Bunkyō, Japan
Aya Fukuizumi, Nippon Medical School, Bunkyō, Japan
Naomi Onda, Nippon Medical School, Bunkyō, Japan
Susumu Takeuchi, Nippon Medical School, Bunkyō, Japan
Kazuo Kasahara, Nippon Medical School, Bunkyō, Japan
Masahiro Seike, Nippon Medical School, Bunkyō, Japan
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