• Tatsuya Nishikawa, Kei Kunimasa, Keiko Ohta-Ogo, Yoshihiko Ikeda, Taku Yasui, Wataru Shioyama, Toru Oka, Keiichiro Honma, Kinta Hatakeyama, Toru Kumagai, and Masashi Fujita.
• Department of Onco-Cardiology, Osaka International Cancer Institute, Japan.
• Intern. Med. 2022 Jul 15; 61 (14): 2161-2165.

AbstractImmune checkpoint inhibitor (ICI)-induced myocarditis is a potentially life-threatening adverse event. We herein report a rare case of sick sinus syndrome (SSS) co-occurring with ICI-associated myocarditis. A 71-year-old woman with lung cancer undergoing pembrolizumab monotherapy was admitted owing to a fever, worsening kidney function, and sinus bradycardia. She was diagnosed with multi-organ immune-related adverse events, including myocarditis. Pulse steroid therapy was initiated immediately under the support of a temporary pacemaker, which resulted in the resolution of SSS in a few days. Biopsy specimens of the endomyocardium showed active myocarditis. Thus, we should be aware that SSS can co-occur with ICI-induced myocarditis.

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