Sicca syndrome/Sjögren’s disease associated with cancer immunotherapy: a narrative review on clinical presentation, biomarkers, and management

Pasoto, Sandra Gofinet; Franco, André Silva; Silva, Clovis Artur; Bonfa, Eloisa

doi:10.1080/1744666x.2024.2370327

Expert Review of Clinical Immunology

2024

DOI: 10.1080/1744666x.2024.2370327

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Sicca syndrome/Sjögren’s disease associated with cancer immunotherapy: a narrative review on clinical presentation, biomarkers, and management

Sandra Gofinet Pasoto,

André Silva Franco,

Clovis Artur Silva

et al.

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Refractory hypokalemia and metabolic acidosis induced by undifferentiated connective tissue disease secondary to immune checkpoint inhibitors: a case report and literature review

Gu,

Yi,

Zou

et al. 2024

Front. Oncol.

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In the past, immune checkpoint inhibitors (ICIs) like camrelizumab have been associated with rheumatic immune-related adverse events (irAEs).To prevent serious adverse consequences, early diagnosis of rheumatic irAEs is crucial. A 40-year-old patient with malignant melanoma experienced severe hypokalemia and fatigue after 6 months of camrelizumab therapy, which was unresponsive to potassium chloride supplementation. Subsequently, the patient was diagnosed with refractory hypokalemia secondary to type I renal tubular acidosis (RTA). After treatment with potassium citrate and hydroxychloroquine, blood potassium, chloride, carbon dioxide binding capacity, and arterial blood gases returned to normal and the fatigue symptoms disappeared. However, severe hypokalemia and fatigue returned following resumption of camrelizumab therapy, and only resolved upon discontinuation and intensified symptomatic treatment. No recurrence of the condition was observed after camrelizumab was discontinued. Refractory hypokalemia and RTA were attributed to undifferentiated connective tissue disease (UCTD), a rheumatic condition considered as an adverse event of camrelizumab. This case underscores the necessity of monitoring serum potassium levels during ICI therapy and the consideration of RTA and autoimmune diseases in cases of hypokalemia to prevent serious adverse consequences.

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Refractory hypokalemia and metabolic acidosis induced by undifferentiated connective tissue disease secondary to immune checkpoint inhibitors: a case report and literature review

Gu,

Yi,

Zou

et al. 2024

Front. Oncol.

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Sicca syndrome/Sjögren’s disease associated with cancer immunotherapy: a narrative review on clinical presentation, biomarkers, and management

Cited by 1 publication

References 146 publications

Refractory hypokalemia and metabolic acidosis induced by undifferentiated connective tissue disease secondary to immune checkpoint inhibitors: a case report and literature review

Refractory hypokalemia and metabolic acidosis induced by undifferentiated connective tissue disease secondary to immune checkpoint inhibitors: a case report and literature review

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