The Drug-Induced Respiratory Disease Website

Pembrolizumab

Pericardial effusion (w/wo tamponade)

Needs be separated from radiation-induced pericardial effusion, underlying disease progression, and from an infection

Publications

Fernández Madrigal L, Montero Pérez O, Rodriguez Garcés MY, Inoriza Rueda Á, Martínez Marcos FJ

Pericardial effusion with pembrolizumab.

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 2022 Feb 08;;10781552221077974 — 2022 Feb 08 — 10781552221077974

Harada K, Ogasawara M, Shido A, Meno A, Oda S, Yoshida S, Yoshida S, Yoshikawa A, Ebata K, Abiko S, Kawagishi N, Sano I, Oda H, Miyagishima T

Pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma: A case report and review of the literature.

Thoracic cancer 2020 Mar 17;; — 2020 Mar 17

Atallah-Yunes SA, Kadado AJ, Soe MH

Pericardial effusion due to pembrolizumab-induced immunotoxicity: A case report and literature review.

Current problems in cancer 2019 Jan 18;; — 2019 Jan 18

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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