Concurrent Hypertrophic Osteoarthropathy and Immune Checkpoint Inhibitor–Induced Inflammatory Arthritis in a Patient With NSCLC: A Case Report

JTO Clinical and Research Reports 2026 Open access

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Authors: Isaac K S Ng, Kaung Myat, Salil Babla Singbal, Victor G.H. Lee, Manjari Lahiri, Sen Hee Tay, May Shuen Tang
DOI: 10.1016/j.jtocrr.2026.101021
Cited by: 1
References: 4

Abstract

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.

Fields of Study & Subjects

Hypertrophic osteoarthropathy and related conditions Inflammatory Myopathies and Dermatomyositis Heterotopic Ossification and Related Conditions

Publication details

Journal / source
JTO Clinical and Research Reports
Publisher
Elsevier BV
Volume
7
Issue
8
Pages
101021–101021
Publication date
20 May 2026
Language
EN