Intravenous immunoglobulin efficacy on pembrolizumab induced severe toxic epidermal necrolysis
Waleed Kian, Melanie Zemel, Firas Elobra, Adam A. Sharb, Dina Levitas, Yarden Assabag, Farouq Alguayn, Alexander Yakobson, Keren Rouvinov, Lior Fuchs
Abstract
Pembrolizumab is an immune checkpoint inhibitor used in many different cancers. Several immune-related adverse events (irAEs) have been associated with pembrolizumab, including toxic epidermal necrolysis. Here, we are presenting a patient with non-small cell lung cancer that developed toxic epidermal necrolysis 3-days following initiation of pembrolizumab. Following high-dose steroid therapy, intravenous immunoglobulin 2 g/kg was initiated and resulted in complete resolution of all his irAEs. To our knowledge, this is the first reported case of total re-epithelialization and resolution of immune checkpoint inhibitor-induced toxic epidermal necrolysis following the use of intravenous immunoglobulin.