Pembrolizumab: Autoimmune myocarditis and pneumonitis.

A 37-year-old woman developed autoimmune myocarditis and pneumonitis while undergoing treatment with pembrolizumab for stage 3 melanoma. She presented with symptoms such as chest pain, tachycardia, fatigue, dyspnea, and fever. Lab studies showed elevated troponin levels and CT scans revealed ground glass opacities in her lungs, indicating pembrolizumab-associated pneumonitis. Echocardiogram results showed a low left ventricular ejection fraction, indicating myocarditis. Despite a negative endomyocardial biopsy, the woman met diagnostic criteria for myocarditis based on elevated troponin levels and abnormalities on cardiac imaging. The autoimmune myocarditis led to heart failure, while the pneumonitis resulted in sepsis, disseminated intravascular coagulation, and respiratory failure. The woman's condition improved with treatment, including corticosteroids, and her left ventricular ejection fraction recovered. The article concludes that pembrolizumab was associated with the development of autoimmune myocarditis and pneumonitis in this case. [Extracted from the article]