Authors
Kei Nagase, Hiroaki Kakinoki, Kazuki Nakamura, Yukako Yamaguchi, Shuhei Kusano, Yuka Kakinoki, Maki Kawasaki, Kazuma Udo, Shohei Tobu, Mitsuru Noguchi
Published in
IJU case reports. Volume 9. Issue 5. Pages e70228. Epub Aug 07, 2026.
Abstract
Cytokine release syndrome (CRS) is a systemic inflammatory response triggered by various factors, including infection and immunotherapy. Due to its nonspecific presentation, distinguishing CRS from other life-threatening conditions remains challenging.
A 79-year-old male receiving lenvatinib plus pembrolizumab for metastatic renal cell carcinoma presented with high-grade fever, altered mental status, and respiratory failure on day 4 of treatment. After excluding infectious etiologies and endocrine dysfunction, CRS was suspected and confirmed by elevated interleukin-6 levels. Lenvatinib and pembrolizumab were discontinued, and the patient was treated with tocilizumab and dexamethasone. Clinical improvement was achieved by day 7.
CRS should be considered a potential cause of unexplained shock in patients receiving immune checkpoint inhibitors. Early diagnostic consideration is vital for timely intervention.
PMID:
42571090
Bibliographic data and abstract were imported from PubMed on 09 Aug 2026.
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