Department of Onco-Cardiology, Osaka International Cancer Institute, Japan.
Department of Thoracic Oncology, Osaka International Cancer Institute, Japan.
Intern Med. 2022 Jul 15;61(14):2161-2165. doi: 10.2169/internalmedicine.8575-21. Epub 2022 Mar 12.
Immune checkpoint inhibitor (ICI)-induced myocarditis is a potentially life-threatening adverse event. We herein report a rare case of sick sinus syndrome (SSS) co-occurring with ICI-associated myocarditis. A 71-year-old woman with lung cancer undergoing pembrolizumab monotherapy was admitted owing to a fever, worsening kidney function, and sinus bradycardia. She was diagnosed with multi-organ immune-related adverse events, including myocarditis. Pulse steroid therapy was initiated immediately under the support of a temporary pacemaker, which resulted in the resolution of SSS in a few days. Biopsy specimens of the endomyocardium showed active myocarditis. Thus, we should be aware that SSS can co-occur with ICI-induced myocarditis.
免疫检查点抑制剂（ICI）诱导性心肌炎是一种潜在危及生命的不良事件。本文报告了一例罕见的免疫检查点抑制剂相关性心肌炎合并病窦综合征（SSS）的病例。一名 71 岁女性，患有肺癌，接受派姆单抗单药治疗，因发热、肾功能恶化和窦性心动过缓而入院。她被诊断为多器官免疫相关不良事件，包括心肌炎。在临时起搏器的支持下，立即开始脉冲类固醇治疗，几天后 SSS 得到缓解。心内膜心肌活检标本显示活动性心肌炎。因此，我们应该意识到 SSS 可能与 ICI 诱导性心肌炎同时发生。
