{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:00:08Z","timestamp":1760144408205,"version":"build-2065373602"},"reference-count":6,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>A 54-year-old woman presented to an outpatient clinic with a recurrence of triple-negative breast cancer and multiple bone metastases. The patient had a large mass lesion of 10 cm on the sternum. She received the immune checkpoint inhibitors pembrolizumab and taxane. Initially, the patient responded excellently to treatment, but stopped pembrolizumab for grade IV skin toxicity with multiple ulcerative wounds over the bilateral leg and trunk. The lesions abated following administration of antibiotics and oral prednisolone for two months. After that, she was referred to the radiation oncology department for further treatment. She received radiotherapy for the sternum mass but stopped radiation at 42Gy\/21 fractions for severe dyspnea and fever. Blood sampling found leukocytosis with neutrophil predominance. Chest radiography showed bilateral lung infiltration. Pulmonary CT scan yielded bilateral lung patchy consolidation compatible with radiation isodose-line. Bronchial lavage showed positive Pneumocystis jiroveci PCR. Dyspnea improved after titrating methylprednisolone within two days. The patient recovered well with TMP-SMX and glucocorticoids after the initiation of therapy.<\/jats:p>","DOI":"10.3390\/diagnostics14080850","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T10:53:17Z","timestamp":1713523997000},"page":"850","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hyperacute Radiation Pneumonitis after Severe irAE"],"prefix":"10.3390","volume":"14","author":[{"given":"Yang","family":"Chou","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Taipei Medical University Hospital, Taipei 11031, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4934-5427","authenticated-orcid":false,"given":"Wei-Kai","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan"},{"name":"Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1186\/s12967-023-04212-5","article-title":"Re-evaluating the risk factors for radiation pneumonitis in the era of immunotherapy","volume":"21","author":"Chen","year":"2023","journal-title":"J. Transl. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1186\/s13014-017-0891-z","article-title":"Exclusion of emphysematous lung from dose-volume estimates of risk improves prediction of radiation pneumonitis","volume":"12","author":"Uchida","year":"2017","journal-title":"Radiat. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1016\/j.ijrobp.2018.04.054","article-title":"Safety of Combined Immunotherapy and Thoracic Radiation Therapy: Analysis of 3 Single-Institutional Phase I\/II Trials","volume":"101","author":"Verma","year":"2018","journal-title":"Int. J. Radiat. Oncol. Biol. 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