Nivolumab-Induced Polymyalgia Rheumatica in a Patient with Lung Adenocarcinoma

Am J Med Sci. 2021 Sep;362(3):321-323. doi: 10.1016/j.amjms.2021.04.010. Epub 2021 Apr 24.

Abstract

A 79-year-old woman was diagnosed with stage IV (cT1aN1M1, OSS) lung adenocarcinoma with bone metastasis of the right femur. She received nivolumab as a third-line treatment. She developed pain in the right shoulder, left wrist, right knee, and waist as well as a low-grade fever and morning stiffness, after five courses of nivolumab. After closer examination, she was diagnosed with polymyalgia rheumatica (PMR) precipitated by an immune-related adverse event. Nivolumab was discontinued, and oral prednisolone was started. Her arthralgia improved. Caution should be exercised regarding the development of PMR when polyarthralgia occurs during nivolumab treatment in patients with lung cancer.

Keywords: Immune-related adverse events (irAEs); Lung adenocarcinoma; Nivolumab; Polyarthralgia; Polymyalgia rheumatica.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma of Lung / diagnosis
  • Adenocarcinoma of Lung / drug therapy*
  • Aged
  • Antineoplastic Agents, Immunological / adverse effects*
  • Female
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy*
  • Nivolumab / adverse effects*
  • Polymyalgia Rheumatica / chemically induced*
  • Polymyalgia Rheumatica / diagnosis

Substances

  • Antineoplastic Agents, Immunological
  • Nivolumab