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This case report presents the first known instance of pembrolizumab-induced autoimmune encephalitis in a 41-year-old female patient with stage IIIc triple-negative breast cancer. The patient developed expressive aphasia three days after starting pembrolizumab in combination with chemotherapy, prompting comprehensive evaluations that ruled out infectious or metastatic causes. A diagnosis of pembrolizumab-associated autoimmune encephalitis was established following a lumbar puncture and MRI.

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Acquired generalized lipodystrophy (AGL) is a rare complication of immune checkpoint inhibitors (ICIs) and is associated with immune-mediated loss of adipose tissue, peripheral resistance to insulin, and serious metabolic complications. Here we report a new case of ICI-induced AGL and provide an updated literature review of published cases. We report a 39-year-old female patient treated with adjuvant pembrolizumab for stage IIIC nevoid melanoma with ICI-induced AGL.

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Article Synopsis
  • * She was diagnosed with hyperglycemia and ketosis, treated for diabetic ketoacidosis (DKA) with insulin, and later transitioned to an insulin regimen after discharge.
  • * The case is significant for recognizing immune checkpoint inhibitor-induced diabetes mellitus (ICI-DM) as a potential side effect of immunotherapy, leading to the discontinuation of her cancer treatment and planning for surgery.
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