Cutaneous and pulmonary sarcoidosis-like reaction associated with ipilimumab

Reule, Ross; North, Jeffrey P.

doi:10.1016/j.jaad.2013.07.028

Cited by 74 publications

(46 citation statements)

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“…Six cases of ipilimumab-induced sarcoidosis-like reactions in melanoma patients have previously been reported. [3][4][5][6][7][8] Three patients received ipilimumab 3 mg/kg and 3 patients received ipilimumab 10 mg/kg. In all cases the lungs and mediastinum was affected and in addition 3 of the patients presented with cutaneous lesions with histopathologic features resembling sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

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Late development of splenic sarcoidosis-like lesions in a patient with metastatic melanoma and long-lasting clinical response to ipilimumab

et al. 2014

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A male patient with Stage IV melanoma was treated with ipilimumab resulting in a long-lasting partial response according to RECIST criteria. However, twenty months after ipilimumab treatment, routine follow-up CT scan revealed new splenic lesions initially interpreted as indicative of progressive disease. Nevertheless, a biopsy was performed and histologic evaluation showed that the lesions did not contain malignant cells but rather constituted non-caseating epithelioid cell granulomas consistent with sarcoidosis. As the patient was asymptomatic no treatment was initiated and over the following months the splenic lesions slowly disappeared and to date the patient remains in remission. Ipilimumab is now widely used in the treatment of melanoma patients. Our case-report illustrates that physicians should consider the possibility of ipilimumab induced visceral sarcoidosis-like reactions, mimicking metastatic lesions, developing even many months after ipilimumab treatment. Thus, biopsy of such suspicious lesions is advisable to avoid misinterpretation as disease progression and unnecessary resumption of cancer therapy.

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Section: Discussionmentioning

confidence: 99%

“…The past few years a small number of cases of ipilimumab-induced sarcoidosis-like reactions in lung and mediastinum have been reported. [3][4][5][6][7][8] Here we report a case of late sarcoidosis-like granulomatosis of the spleen in a patient previously treated with ipilimumab for metastatic melanoma.…”

Section: Introductionmentioning

confidence: 99%

Late development of splenic sarcoidosis-like lesions in a patient with metastatic melanoma and long-lasting clinical response to ipilimumab

et al. 2014

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“…Ipilimumab (a monoclonal antibody directed against cytotoxic T-lymphocyte antigen-4) 62 Ophthalmic drops containing sodium bisulfite 61 a The most common drug inducing the reaction. Granulomatous Drug Eruptions sarcoidosis was found in 47 cases.…”

Section: Desensitization Injections 81mentioning

confidence: 99%

“…58,59,62,63 In the case of sarcoidosis-like reaction associated with ipilimumab, shortness of breath and hypoxemia requiring supplemental oxygen were signs of pulmonary involvement in addition to the cutaneous manifestations. 62 In a review of the literature on cutaneous signs of IFN-a-induced sarcoidosis, 63 nonspecific respiratory symptoms were noted in 54% and mediastinal lymphadenopathy in 50% of the patients. It should be mentioned that many cases of sarcoidosis developing while on anti-TNF therapy involve organs other than the skin, 59 with lung and surrounding lymph nodes the most commonly affected.…”

Section: Systemic Associationsmentioning

confidence: 99%

“…65 Few cases of persistent or relapsing course require immunosuppressive treatment. 58,62,64 In the cases of hyaluronic acid injections inducing cutaneous sarcoidosis, 64 and cutaneous and pulmonary sarcoidosis-like reaction associated with ipilimumab, 62 prednisone treatment improved the symptoms. In a retrospective case review assessing 34 cases of sarcoidosis developing during anti-TNF therapy, 58 the primary treatment for 33 of the 34 cases was discontinuation of the TNF-inhibitor therapy.…”

Section: Evaluation and Managementmentioning

confidence: 99%

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Granulomatous Drug Eruptions

Dodiuk‐Gad

Shear

2015

Dermatologic Clinics

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Suspected immune checkpoint inhibitor‐induced pulmonary sarcoid reaction in metastatic renal cell carcinoma

Purcell

Preti

Fernandes

2022

Clinical Case Reports

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We present the case of a 50-year-old male patient with metastatic clear cell renal cell carcinoma (mRCC) who developed a diffuse pulmonary opacification and lymphadenopathy during nivolumab maintenance therapy. This was diagnosed as presumed sarcoid granulomatous inflammatory reaction secondary to immunotherapy, which resolved with holding off therapy and the nivolumab was resumed. K E Y W O R D Simmune-related adverse events, immunotherapy, metastatic renal cell carcinoma, sarcoid-like reactions How to cite this article: Purcell V, Preti B, Fernandes R. Suspected immune checkpoint inhibitor-induced pulmonary sarcoid reaction in metastatic renal cell carcinoma.

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Cutaneous and pulmonary sarcoidosis-like reaction associated with ipilimumab

Cited by 74 publications

References 3 publications

Late development of splenic sarcoidosis-like lesions in a patient with metastatic melanoma and long-lasting clinical response to ipilimumab

Late development of splenic sarcoidosis-like lesions in a patient with metastatic melanoma and long-lasting clinical response to ipilimumab

Granulomatous Drug Eruptions

Suspected immune checkpoint inhibitor‐induced pulmonary sarcoid reaction in metastatic renal cell carcinoma

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