Pembrolizumab-Induced Mobitz Type 2 Second-Degree Atrioventricular Block
Pembrolizumab is a monoclonal antibody directed towards programmed cell death protein 1 (PD-1) and is an antineoplastic drug which has a growing variety of oncologic uses. Pembrolizumab is commonly associated with immune-related adverse events (IRAEs) but is infrequently noted to cause cardiotoxicit...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2020/8428210 |
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| _version_ | 1832566136957304832 |
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| author | Alisha Khan Sana Riaz Robert Carhart |
| author_facet | Alisha Khan Sana Riaz Robert Carhart |
| author_sort | Alisha Khan |
| collection | DOAJ |
| description | Pembrolizumab is a monoclonal antibody directed towards programmed cell death protein 1 (PD-1) and is an antineoplastic drug which has a growing variety of oncologic uses. Pembrolizumab is commonly associated with immune-related adverse events (IRAEs) but is infrequently noted to cause cardiotoxicities such as myocarditis, arrhythmias, and heart failure. The following case report illustrates the clinical course of a 67-year-old female patient with stage IV non-small-cell lung cancer who developed Mobitz type 2 second-degree atrioventricular block three weeks after receiving her first infusion of pembrolizumab. Within a few hours of presentation, she progressed to symptomatic complete heart block requiring emergent placement of a temporary transvenous pacemaker. The article further discusses proposed mechanisms to explain IRAEs and management of IRAEs. We conclude by recommending a higher degree of caution and awareness among all physicians when treating patients on immunotherapy and a multidisciplinary approach when considering resumption of immune checkpoint inhibitor therapy. |
| format | Article |
| id | doaj-art-6d237def85fb470d8935f906c79b2492 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-6d237def85fb470d8935f906c79b24922025-02-03T01:05:00ZengWileyCase Reports in Cardiology2090-64042090-64122020-01-01202010.1155/2020/84282108428210Pembrolizumab-Induced Mobitz Type 2 Second-Degree Atrioventricular BlockAlisha Khan0Sana Riaz1Robert Carhart2Department of Medicine, SUNY Upstate Medical University, USADepartment of Medicine, SUNY Upstate Medical University, USADepartment of Cardiology, SUNY Upstate Medical University, USAPembrolizumab is a monoclonal antibody directed towards programmed cell death protein 1 (PD-1) and is an antineoplastic drug which has a growing variety of oncologic uses. Pembrolizumab is commonly associated with immune-related adverse events (IRAEs) but is infrequently noted to cause cardiotoxicities such as myocarditis, arrhythmias, and heart failure. The following case report illustrates the clinical course of a 67-year-old female patient with stage IV non-small-cell lung cancer who developed Mobitz type 2 second-degree atrioventricular block three weeks after receiving her first infusion of pembrolizumab. Within a few hours of presentation, she progressed to symptomatic complete heart block requiring emergent placement of a temporary transvenous pacemaker. The article further discusses proposed mechanisms to explain IRAEs and management of IRAEs. We conclude by recommending a higher degree of caution and awareness among all physicians when treating patients on immunotherapy and a multidisciplinary approach when considering resumption of immune checkpoint inhibitor therapy.http://dx.doi.org/10.1155/2020/8428210 |
| spellingShingle | Alisha Khan Sana Riaz Robert Carhart Pembrolizumab-Induced Mobitz Type 2 Second-Degree Atrioventricular Block Case Reports in Cardiology |
| title | Pembrolizumab-Induced Mobitz Type 2 Second-Degree Atrioventricular Block |
| title_full | Pembrolizumab-Induced Mobitz Type 2 Second-Degree Atrioventricular Block |
| title_fullStr | Pembrolizumab-Induced Mobitz Type 2 Second-Degree Atrioventricular Block |
| title_full_unstemmed | Pembrolizumab-Induced Mobitz Type 2 Second-Degree Atrioventricular Block |
| title_short | Pembrolizumab-Induced Mobitz Type 2 Second-Degree Atrioventricular Block |
| title_sort | pembrolizumab induced mobitz type 2 second degree atrioventricular block |
| url | http://dx.doi.org/10.1155/2020/8428210 |
| work_keys_str_mv | AT alishakhan pembrolizumabinducedmobitztype2seconddegreeatrioventricularblock AT sanariaz pembrolizumabinducedmobitztype2seconddegreeatrioventricularblock AT robertcarhart pembrolizumabinducedmobitztype2seconddegreeatrioventricularblock |