Clinical Report: Pembrolizumab Reveals Capillary Leak Syndrome Accompanied by Chylothorax in Early Triple-Negative Breast Cancer
Overview
This case study presents a rare instance of capillary leak syndrome (CLS) and chylothorax in a patient with early-stage triple-negative breast cancer (TNBC) following pembrolizumab treatment. The patient experienced significant symptoms and was treated with corticosteroids after extensive diagnostic evaluation.
Background
Pembrolizumab is increasingly used in early-stage TNBC, improving survival outcomes. However, its use can lead to rare immune-related adverse events (irAEs), including CLS, which can be life-threatening.
Data Highlights
No numerical data or trial data presented in the article.
Key Findings
A 40-year-old female with early-stage TNBC developed CLS and chylothorax after two cycles of pembrolizumab.
Symptoms included progressive dyspnea, diffuse subcutaneous edema, and pleural effusions.
Imaging confirmed polyserositis and interstitial pulmonary edema, while laboratory tests showed hypoalbuminemia.
Thoracentesis revealed chylothorax with milky pleural fluid containing chylomicrons.
Corticosteroid therapy led to rapid clinical and radiologic resolution, and pembrolizumab was permanently discontinued.
Clinical Implications
Clinicians should be aware of the potential for CLS in patients receiving pembrolizumab, especially when unexplained serous effusions and edema occur.
Conclusion
This case highlights the importance of recognizing rare irAEs such as CLS in patients treated with pembrolizumab for TNBC.
