Khachatryan Aleksan, Alejandro Joel M, Chow Robert D, Haque Reyaz U, Mikdashi Jamal A
Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, USA.
Cardiology, University of Maryland Medical Center Midtown Campus, Baltimore, USA.
Cureus. 2023 Aug 2;15(8):e42867. doi: 10.7759/cureus.42867. eCollection 2023 Aug.
Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that target T lymphocytes and stimulate the immune system. However, the use of ICIs is associated with immune-related adverse events (irAEs). Pericardial disease is a cardiovascular irAEs that can present as cardiac tamponade. The precise mechanisms underlying pericardial complications are not fully understood. Late-onset hemorrhagic pericardial effusion associated with ICIs is quite rare; the mechanism and predisposing factors are yet to be determined. This case report describes a patient with diffuse large B-cell lymphoma (DLBCL) who received pembrolizumab for 390 days and subsequently developed cardiac tamponade caused by hemorrhagic pericardial effusion. The purpose of this report is to raise awareness about the occurrence of late-onset cardiac tamponade and provide a summary of available data on patients who experienced hemorrhagic pericardial effusion during ICI treatment.
免疫检查点抑制剂（ICIs）是靶向T淋巴细胞并刺激免疫系统的单克隆抗体。然而，使用ICIs与免疫相关不良事件（irAEs）有关。心包疾病是一种可表现为心脏压塞的心血管irAEs。心包并发症的确切机制尚未完全明确。与ICIs相关的迟发性出血性心包积液非常罕见；其机制和易感因素尚待确定。本病例报告描述了一名弥漫性大B细胞淋巴瘤（DLBCL）患者，该患者接受帕博利珠单抗治疗390天后，随后出现由出血性心包积液导致的心脏压塞。本报告的目的是提高对迟发性心脏压塞发生的认识，并总结ICI治疗期间发生出血性心包积液患者的现有数据。
