Vogt-Koyanagi-Harada-like Syndrome Complicating Pembrolizumab Treatment for Metastatic Melanoma.
Vogt-Koyanagi-Harada (VKH) syndrome is a rare condition implicating systemic immune reaction against melanocytes. The pathophysiology is unclear. A genetic predisposition has been suggested as HLA-DR4/DRB1*04 is more common among VKH patients. Drug induced VKH syndrome has been reported in advanced melanoma patients receiving immunotherapy, including ipilimumab and adoptive cell transfer of Tumor-Infiltrating Lymphocyte associated with IL-2. To date, no case of anti PD-1 -induced VKH syndrome has been described. We report here the case of a HLA-DR4/DRB1*04 patient successfully treated with anti PD-1 for advanced melanoma who developed a systemic immune reaction against melanocytes for whom we discuss a VKH-like syndrome diagnosis in a potentially genetically predisposed patient.
Departments of *Ophthalmology †Dermatology, LYON SUD Hospital Center, Hospices Civils of Lyon, Pierre Bénite Cedex Departments of ‡Internal Medicine §Ophthalmology, Croix-Rousse Hospital, Hospices Civils of Lyon, Lyon, France.
Marion
M
Bricout
Adeline
A
Petre
Mona
M
Amini-Adle
Widad
W
Bezza
Pascal
P
Seve
Laurent
L
Kodjikian
Stéphane
S
Dalle
Luc
L
Thomas
D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis* / Q000235:genetics; D020022:Genetic Predisposition to Disease; D015804:HLA-DR4 Antigen / Q000235:genetics; D059811:HLA-DRB1 Chains / Q000235:genetics; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008544:Melanocytes / Q000276:immunology; D008545:Melanoma / Q000188:drug therapy* / Q000556:secondary; D008582:Meningitis, Aseptic / Q000175:diagnosis* / Q000209:etiology / Q000235:genetics; D008875:Middle Aged; D061026:Programmed Cell Death 1 Receptor / Q000276:immunology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000556:secondary; D014605:Uveitis / Q000175:diagnosis* / Q000209:etiology / Q000235:genetics; D014607:Uveomeningoencephalitic Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000235:genetics
D061067:Antibodies, Monoclonal, Humanized; D015804:HLA-DR4 Antigen; D059811:HLA-DRB1 Chains; C527195:HLA-DRB1*04 antigen; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor; C582435:pembrolizumab