Lagos-Villaseca Antonia, Koshkin Vadim S, Kinet Maxime J, Rosen Clark A
UCSF Voice & Swallowing Center, Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, San Francisco, California; Department of Otolaryngology, Pontificia Universidad Católica de Chile, Santiago, Chile.
Division of Hematology/Oncology, Department of Medicine, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California.
J Voice. 2025 Jul;39(4):890-895. doi: 10.1016/j.jvoice.2022.12.028. Epub 2023 Jan 18.
Pembrolizumab is an immune checkpoint inhibitor (ICI) approved for multiple indications in a variety of malignancies. Although generally well tolerated, the potential for significant adverse effects, specifically immune related adverse effects (irAEs) needs to be taken into consideration. Several cases of bullous pemphigoid have been reported as a cutaneous adverse effect of ICIs since 2015, and there are recent reports of mucous membrane pemphigoid (MMP). We present the case of an 84-year-old male with metastatic urothelial carcinoma on treatment with pembrolizumab, who developed laryngeal mucous membrane pemphigoid as an irAE. The diagnosis was based on patient's clinical history and serologic testing, and supported by symptomatic improvement after ICI discontinuation and immunosuppression. Pembrolizumab-induced MMP is a newly described and infrequent irAE, requiring early suspicion and close monitoring for its diagnosis and management.
帕博利珠单抗是一种免疫检查点抑制剂（ICI），已被批准用于多种恶性肿瘤的多种适应症。尽管总体耐受性良好，但仍需考虑其产生严重不良反应的可能性，特别是免疫相关不良反应（irAE）。自2015年以来，已有数例大疱性类天疱疮病例被报道为ICI的皮肤不良反应，最近也有黏膜类天疱疮（MMP）的报道。我们报告一例84岁男性转移性尿路上皮癌患者，在用帕博利珠单抗治疗期间发生喉黏膜类天疱疮，作为一种irAE。诊断基于患者的临床病史和血清学检测，并在停用ICI和进行免疫抑制后症状改善得到支持。帕博利珠单抗诱导的MMP是一种新描述的罕见irAE，需要早期怀疑并密切监测以进行诊断和管理。
