Anti-synthetase syndrome-associated interstitial lung disease possibly caused by atezolizumab in a patient with lung adenocarcinoma: a case report

BMC Pulm Med. 2023 May 8;23(1):159. doi: 10.1186/s12890-023-02446-z.

Abstract

Background: Anti-aminoacyl-tRNA synthetase (ARS) antibody-positive patients present with a variety of symptoms, including interstitial lung disease (ILD), which is termed anti-synthetase syndrome (ASS). But it is rare that ASS-ILD is considered an immune-related adverse event after the use of immune checkpoint inhibitors (ICIs).

Case presentation: A 47-year-old male with advanced lung adenocarcinoma was treated with platinum and ICI combination immunotherapy and was followed up as an outpatient. Nine months after the start of treatment, he developed a fever and cough, and imaging findings showed lung consolidations in the bilateral lower lung fields. The patient was positive for anti- ARS antibodies and was considered to have developed ASS-ILD due to ICIs remitted with steroid therapy. The patient was found to be positive for anti-ARS antibodies before ICI administration, and the antibody titer was elevated compared to that before ICI administration.

Conclusions: The examination of anti-ARS antibodies pior to the administration of ICIs may be useful in predicting the development of ASS-ILD.

Keywords: Aminoacyl-tRNA synthetase (ARS); Anti-synthetase syndrome (ASS); Immune checkpoint inhibitors (ICIs); Interstitial lung disease; Lung cancer.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma of Lung* / complications
  • Adenocarcinoma of Lung* / drug therapy
  • Humans
  • Ligases
  • Lung Diseases, Interstitial* / chemically induced
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Male
  • Middle Aged
  • Outpatients
  • Syndrome

Substances

  • atezolizumab
  • Ligases