{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T20:03:53Z","timestamp":1788206633173,"version":"build-2803163510"},"reference-count":19,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Systemic Capillary Leak Syndrome (SCLS) and Cytokine Release Syndrome (CRS) have both been described as rare but severe adverse reactions induced by Programmed cell death protein 1 (PD-1) inhibitors such as pembrolizumab. We report the case of a 40-year-old woman undergoing treatment with pembrolizumab for a stage 4 cervical squamous cell carcinoma who presented with anasarca, hypotension, hemoconcentration and signs of multisystemic inflammation. After elimination of alternative causes such as nephrotic syndrome, cardiac dysfunction and cirrhosis, she was diagnosed with both pembrolizumab-induced SCLS and CRS. She was successfully treated with a multimodal treatment approach including intravenous immunoglobulins, steroids, diuretics and axitinib for SCLS as well as ruxolitinib for CRS. After several months of hospitalization, her symptoms finally improved with this treatment regimen, and she was able to attain euvolemic state and be discharged from the hospital. This case highlights certain rare and severe adverse effects of treatment with PD-1 inhibitors. Furthermore, it proposes a novel therapeutic approach for similar cases based upon probable underlying physiopathological mechanisms in SCLS and CRS.<\/jats:p>","DOI":"10.3390\/curroncol32080469","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T13:28:22Z","timestamp":1755523702000},"page":"469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pembrolizumab-Induced Simultaneous and Refractory Systemic Capillary Leak and Cytokine Release Syndromes: A Case Report"],"prefix":"10.3390","volume":"32","author":[{"given":"Eug\u00e9nie","family":"Roberge-Maltais","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Universit\u00e9 Laval, Quebec City, QC G1V 0A6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"L\u00e9vesque","sequence":"additional","affiliation":[{"name":"Department of Hemato-Oncology, CHU de Quebec, Universit\u00e9 Laval, Quebec City, QC G1V 4G2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Castonguay","sequence":"additional","affiliation":[{"name":"Department of Hemato-Oncology, CHU de Quebec, Universit\u00e9 Laval, Quebec City, QC G1V 4G2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1422-6716","authenticated-orcid":false,"given":"Nicolas","family":"Marcoux","sequence":"additional","affiliation":[{"name":"Department of Hemato-Oncology, CHU de Quebec, Universit\u00e9 Laval, Quebec City, QC G1V 4G2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6718-6160","authenticated-orcid":false,"given":"Louis-Philippe","family":"Grenier","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, CHU de Quebec\u2014Pavillon H\u00f4tel-Dieu de Qu\u00e9bec, Universit\u00e9 Laval, Quebec City, QC G1R 2J6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Veilleux","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, CHU de Quebec\u2014Pavillon H\u00f4tel-Dieu de Qu\u00e9bec, Universit\u00e9 Laval, Quebec City, QC G1R 2J6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/S0140-6736(24)00317-9","article-title":"Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11\/GOG-3047\/KEYNOTE-A18): A randomised, double-blind, phase 3 clinical trial","volume":"403","author":"Lorusso","year":"2024","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Seidel, J.A., Otsuka, A., and Kabashima, K. 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