Xu Ruo-Wen, Dong Wen-Bo, Wang Yong-Xu, Liu Yong-Qi, Chen Chen, Wang Wei, Liu Hai-Na, Jin Hong-Yu, Li Wen-Yang
Respiratory and Critical Care Department, The First Hospital of China Medical University, Shenyang, China.
First Clinical College, China Medical University, Shenyang, China.
Front Immunol. 2025 Aug 14;16:1619229. doi: 10.3389/fimmu.2025.1619229. eCollection 2025.
BACKGROUND: Up to 22% of cancer patients treated with immune checkpoint inhibitors (ICIs) can experience immune-related adverse events (irAEs) that mimic rheumatic disease, such as relapsing polychondritis (RP), which is a rare autoimmune disease that mainly manifests as inflammation of airway cartilage. METHODS: We report a case of RP induced by humanized recombinant anti-PD-1 monoclonal antibody therapy (tislelizumab). 18F-Fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) contributed to the diagnosis of RP, and methylprednisolone was used to effectively control its progression. We also reviewed 13 publications on drug-induced RP in the context of cancer and analyzed the pathogenesis, ancillary tests, treatment, and prognosis of the cases described therein. RESULTS: Including our case, 14 drug-related RP cases with a tumor background were analyzed. Patients usually develop related symptoms 3-5 months after initiating medication. The primary tumor involvement sites included the hematological system (5/14, 35.71%), upper digestive tract (4/14, 28.57%), skin (2/14, 14.29%), reproductive system (2/14, 14.29%), bone (1/14,7.14%), and lung (1/ 14, 7.14%). CONCLUSION: 18F-FDG PET/CT plays a crucial role in diagnosing RP caused by PD-1 monoclonal antibodies. Early detection and the prompt administration of corticosteroids are crucial in effectively controlling the progression of RP, helping to alleviate symptoms and prevent further complications.
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