{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T21:36:50Z","timestamp":1792618610523,"version":"4.5.0"},"reference-count":11,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T00:00:00Z","timestamp":1627516800000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2021,5,27]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>Cytokine release syndrome (CRS) is a well-described immune-related adverse event following chimeric antigen receptor T-cell therapy, but has rarely been reported following anti-programmed death ligand-1 therapy. We report the case of a 55-year-old man with metastatic lung adenocarcinoma who presented with fever, chills and hypotension. Initial labs were notable for highly elevated serum ferritin levels and mildly elevated triglyceride levels. He was ultimately diagnosed with pembrolizumab-induced CRS complicated by multiorgan failure. The patient was treated with steroids and tocilizumab with normalization of inflammatory markers and resolution of renal failure. This case not only highlights the importance of considering CRS in patients who have developed multiorgan failure after immune checkpoint inhibitor therapy, but also demonstrates clinical similarities between CRS and other hyperinflammatory states such as hemophagocytic lymphohistiocytosis.<\/jats:p>","DOI":"10.1136\/jitc-2021-002855","type":"journal-article","created":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T10:31:27Z","timestamp":1627641087000},"page":"e002855","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report"],"prefix":"10.1136","volume":"9","author":[{"given":"Paul","family":"Sackstein","sequence":"first","affiliation":[{"name":"Internal Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Zaemes","sequence":"additional","affiliation":[{"name":"Internal Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0191-8684","authenticated-orcid":false,"given":"Chul","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,30]]},"reference":[{"key":"2025100306355853000_9.7.e002855.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32409-7"},{"key":"2025100306355853000_9.7.e002855.2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3008226"},{"key":"2025100306355853000_9.7.e002855.3","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-018-0365-3"},{"key":"2025100306355853000_9.7.e002855.4","doi-asserted-by":"crossref","first-page":"e55","DOI":"10.1016\/j.jtho.2018.11.025","article-title":"Cytokine release syndrome with pseudoprogression in a patient with advanced non-small cell lung cancer treated with pembrolizumab","volume":"14","author":"Kogure","year":"2019","journal-title":"J Thorac Oncol"},{"key":"2025100306355853000_9.7.e002855.5","doi-asserted-by":"crossref","first-page":"309","DOI":"10.2217\/imt-2016-0134","article-title":"Diffuse edema suggestive of cytokine release syndrome in a metastatic lung carcinoma patient treated with pembrolizumab","volume":"9","author":"Rassy","year":"2017","journal-title":"Immunotherapy"},{"key":"2025100306355853000_9.7.e002855.6","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-019-0582-4"},{"key":"2025100306355853000_9.7.e002855.7","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"2025100306355853000_9.7.e002855.8","doi-asserted-by":"crossref","first-page":"2613","DOI":"10.1002\/art.38690","article-title":"Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome","volume":"66","author":"Fardet","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"2025100306355853000_9.7.e002855.9","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/PPO.0000000000000515","article-title":"Cytokine release syndrome biology and management","volume":"27","author":"Cobb","year":"2021","journal-title":"Cancer J"},{"key":"2025100306355853000_9.7.e002855.10","first-page":"107815522098081","article-title":"Acute cytokine release syndrome after a first dose of pembrolizumab as second-line treatment for metastatic, programmed death-ligand 1-positive, non-small-cell lung cancer","author":"Normand","year":"2020","journal-title":"J Oncol Pharm Pract"},{"key":"2025100306355853000_9.7.e002855.11","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-018-0434-7"}],"container-title":["Journal for ImmunoTherapy of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jitc-2021-002855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T13:36:07Z","timestamp":1759498567000},"score":1,"resource":{"primary":{"URL":"https:\/\/jitc.bmj.com\/lookup\/doi\/10.1136\/jitc-2021-002855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":11,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,30]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/jitc-2021-002855"],"URL":"https:\/\/doi.org\/10.1136\/jitc-2021-002855","relation":{},"ISSN":["2051-1426"],"issn-type":[{"value":"2051-1426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}