JTO Clinical and Research Reports · Published 2026-05-20 · DOI 10.1016/j.jtocrr.2026.101021
Isaac K.S. Ng, Kaung Myat, Salil B. Singbal, Victor G.H. Lee, Manjari Lahiri, Sen Hee Tay, May Shuen Tang
Hypertrophic osteoarthropathy (HOA) is a prototypical paraneoplastic arthritis associated with lung cancer, specifically NSCLC. With the increasing use of immune checkpoint inhibitors (ICIs), ICI-induced inflammatory arthritis (IA) is another important differential diagnosis for joint pain in patients with lung cancer. We report, to our knowledge, the first case of a patient with stage 4 lung adenocarcinoma and paraneoplastic HOA who subsequently developed ICI-IA and cytokine release syndrome while receiving the PD-1 inhibitor, pembrolizumab. Differentiating between HOA and ICI-IA is essential because of their differing treatment implications, requiring careful clinical assessment with adjunctive biochemical (including cytokine profiling), radiological, and synovial fluid investigations.
Abstract from DOAJ. Public domain (CC0 1.0).
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Ng, I., Myat, K., Singbal, S., et al. (2026). Concurrent Hypertrophic Osteoarthropathy and Immune Checkpoint Inhibitor–Induced Inflammatory Arthritis in a Patient With NSCLC: A Case Report. JTO Clinical and Research Reports. https://doi.org/10.1016/j.jtocrr.2026.101021